Remote Physician Reviewer — Utilization & Care Quality
ChenMed LLC
- Remote job
ChenMed LLC is seeking a Physician Reviewer to lead delegated utilization management (UM) reviews across multiple markets. You will establish daily case counts, attend essential calls with health plans, advise other reviewers, and participate in ongoing process and quality improvements. A strong medical background with licensure and board certification is required. Two years in hospital medicine and at least one year in utilization review are preferred, with excellent analytical and #J-18808-Ljbffr ChenMed LLC
- ...A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or... ...ensuring high standards of patient care. Responsibilities include... ...home while contributing to quality medical reviews. #J-18808-Ljbffr...Remote workQualityFull timeWork from home
- ...Place to Work" company is seeking a Physician to provide utilization review services for the Group Health Department... ...team contributions every day. We care for our customers, each other, and... ...due date and time. Assist with quality assurance of reports prior to submission...Remote workQuality
- ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide accurate coverage determinations for inpatient and outpatient... ..., and internal policies. You will coordinate with care teams to ensure medically appropriate care is delivered...Remote workFull time
- ...ChenMed in Miami, Florida is seeking a Physician Reviewer to lead Utilization Management reviews, advise other physician reviewers, and coordinate care with health plans and local teams to... .... The role emphasizes process and quality improvement in delegated UM, demands...QualityLocal area
- tango is seeking a Physician Reviewer to join our remote, full-time team. You will perform real-time utilization management case reviews, apply evidence-based guidelines, and conduct... ...and clinical management to support quality improvement, ensure regulatory compliance,...Remote jobQualityFull timeFlexible hours
- Comagine Health is seeking a Clinical Reviewer to work remotely from Oregon with travel across the... ...ensuring timely decisions and high-quality care. The role requires licensure, 3 years... ...behavioral health, and familiarity with utilization review. #J-18808-Ljbffr Comagine...Remote jobQuality
- ...and monitoring the utilization of behavioral... ...Medical Director for review. Refer to and work... ...benefits, and efficient care delivery processes... ...refers potential quality of care and... ...with the treating physician or other providers... ...The opportunity for remote work may be possible...Remote workQualityContract workWork at office
$248.5k - $373k
...or family medicine physician to join our Utilization Management team. Optum... ...is a clinician-led care organization that is... ...flexibility to work remotely * from anywhere within... ...in case review and medical necessity... ...confidentiality Provides quality assurance and education...Remote workQualityMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$248.5k - $373k
...or family medicine physician to join our Utilization Management team. Optum... ...is a clinician-led care organization that is... ...Participates in case review and medical... ...confidentiality Provides quality assurance and education... ...employees working remotely will be required to...Remote workQualityMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$213.1k - $383.58k
...1977 as the Senior Care Action Network, SCAN... .... The Job The Utilization Management (UM) Physician Medical Director provides... ..., concurrent review, and appeals programs... ...policy development, quality oversight, and provider... ...Work Mode - Mostly Remote: Employees who reside...Remote workQualityFull timeFor contractorsWork at officeLocal areaRelocation- ChenMed is seeking a Physician Reviewer to lead Utilization Management (UM) reviews across assigned markets and coordinate care for our patients. You will cover delegated UM, attend health... ...and local calls, and participate in quality improvement within our growing UM area...QualityLocal area
- ChenMed in Miami, FL is seeking a Physician Reviewer for Utilization Management. You will review UM cases, advise peers, and participate... ...and local team calls to coordinate patient care. The role includes process and quality improvement in a developing area of Delegated...QualityLocal area
$204.76k - $292.52k
...Physician Reviewer We're unique. You should be, too. We're changing... ...different than most primary care providers. We're rapidly expanding... ...physician reviewer for Utilization Management (UM) cases in our... ...participate in Process and Quality improvement in our developing...Remote workQualityHourly payFull timeWork at officeLocal area- ...A leading independent review organization is seeking a Utilization Management Physician Reviewer for a full-time remote role. Candidates must possess an active Nebraska medical license and have a minimum of 5 years clinical practice experience. Responsibilities include...Remote workFull timeCasual workMonday to Friday
- ...AmeriHealth Caritas is seeking a BHUM Reviewer to conduct medical necessity... ...use to support appropriate, timely care. Candidates should have nursing... ...work credentials, experience in utilization management, and the ability to work remotely within the US; remote options and...Remote workWeekday work
- ...Integrity (CDI) Second Level Reviewer The Clinical... ...complexity of patient care. Serves as key resource for CDI/Coding/Quality. The CDI Second Level Reviewer... ...and reporting physician and hospital outcomes.... ...quality documentation by utilizing queries that are effective...Remote workQualityWork at office
- ...Role Overview Our Utilization Management Reviewers evaluate medical... ...judgment, the Clinical Care Reviewer assesses the... ...turnaround times, quality benchmarks, and efficiency... ...cases requiring physician review or additional... ...solutions include remote options, hybrid work...Remote workQualityMonday to FridayFlexible hoursWeekend work
- ...Remote Hialeah, FL Miami, FL Full... ...position, please review this tip sheet ( .... ...complexity of patient care. Serves as key... ...resource for CDI/Coding/Quality. The CDI Second... ...and reporting physician and hospital outcomes... ...documentation by utilizing queries that are effective...Remote workQualityFull timeTemporary workWork at officeWorldwide
- ...experienced DRG Clinical Physician Reviewer to join our growing... .... This is a fully remote opportunity for a... ...strong background in utilization review and clinical validation... ...impact healthcare quality and reimbursement... ...readmission and level of care reviews, including...Remote workQuality
$86k - $117.3k
...roles that are 100% remote or hybrid, you must... ...helping people get care, stay well, and build... ...of a supervisor, the Utilization Management Reviewer evaluates medical necessity... ...cases requiring physician review or additional... ...times, and quality standards in a high-...Remote workQualityHourly payContract workMonday to FridayFlexible hoursWeekend work- Physician Reviewer - Texas Counter Affidavit Work (Orthopedic Surgery) job... ...question posed by the client utilizing client‑specific criteria or... ...identifying and responding to quality assurance issues, complaints... ...stipend is provided for remote work space. Come up to speed...Remote workQualityFor contractorsWork experience placement
- PHYSICIAN REVIEWER Independent Medical Review | Remote Opportunity Organization : Christopher Place... ...health plans, and managed care organizations... ...contribute to healthcare quality and appropriate medical... ...Experience performing utilization review, peer review, independent...Remote jobQualityFlexible hoursWeekend workWeekday work
- ...Health is seeking a Clinical Reviewer with LCSW/LPC/LCPC licensure for a remote, Oregon-based role... ...home and community-based care for diverse populations.... ...The position emphasizes utilization review, documentation, and... ...while supporting quality initiatives. #J-18808-Ljbffr...Remote jobQualityWork from home
$219k - $286.9k
Oscar Health is hiring a Physician Reviewer to join our Utilization Management team. You will determine the medical appropriateness of inpatient, outpatient... ...and applying evidence-based guidelines. This remote role in the United States offers work from home with occasional...Remote jobWork from home- ChenMed LLC seeks a physician with strong clinical and UM background to cover delegated utilization management across multiple territories. The role requires residency in... ...years in hospital medicine, with utilization review experience preferred. You will coordinate with...Remote job
$130 - $145 per hour
...hiring a Behavioral Health Physician Reviewer to join our Utilization Management team. Oscar is... ..., case management, and quality improvement programs meet... ...: This position is fully remote and open to candidates residing... ...health managed care, utilization review or equivalent...Remote workQualityHourly payFull timePart timeWork from homeHome office$155 - $165 per hour
...poster from EPITEC As a Physician Reviewer, you'll play a critical role... ...our members receive high-quality, cost-effective care. You'll work closely with... ...with managed care and utilization management Strong leadership... ...What We Offer Fully remote work arrangement (Weekends...Remote workQualityFull timeContract workWork at officeWeekend work- ...and services designed to manage the total cost of care. We are currently looking for a Physician Reviewer to join our growing team on a full time basis. The... ...reviews, peer-to-peer discussions and education across utilization management, provider relations, and clinical #J-1...Remote jobFull time
- ...manage the total cost of care. We are currently looking for a Physician Reviewer to join our growing... ...Physician Reviewer is in a utilization management reviewer... ...support. Office Location Remote - flexible hours... ...services. Reviews Potential Quality Issues (PQIs). The Physician...Remote jobQualityFull timeWork at officeLocal areaWork from homeFlexible hours
- A recognized healthcare provider is seeking a Board Certified Orthopaedic Spine Surgeon to conduct utilization reviews. This telework position allows for a flexible schedule within a standard Monday - Friday work week. Responsibilities include reviewing medical records,...Remote jobFor contractorsMonday to FridayFlexible hours
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