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
- ...ChenMed is looking for a Licensed Physician Reviewer – Ortho for a remote role based in Miami, FL. This position involves conducting Utilization Management reviews and advising other physician... ...reviewers while participating in quality improvement efforts. The ideal...Remote workQuality
- ...management organization is seeking experienced Physician Reviewers to join their Medicare Utilization Management team in a remote position. Responsibilities include... ...based guidelines, and collaborating to ensure quality care for members. Candidates must be board-certified...Remote workQuality
- ...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
- ...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... ...care in behavioral health, and familiarity with utilization review. #J-18808-Ljbffr...Remote workQuality
- ...Orthopedic Spine Surgeon Reviewer Dane Street, a... ...expanding its panel of Physician Reviewers. We are currently... ...Certification to conduct Utilization Reviews. This is a fully remote, non-clinical role offering... ...physicians to ensure high-quality, evidence-based clinical...Remote workQualityPrice workExtra incomeFor contractorsFlexible hours
$219k - $286.9k
...Physician Reviewer - Utilization Management Hi, we're Oscar. We're hiring a Physician... ...Work Location: This is a remote position, open to candidates... ...that meet Oscar's stringent quality parameters. Provide... ...review experience in a managed care plan (health care industry)...Remote workQualityFull timeLocal areaWork from homeHome officeWeekend work- 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 jobQualityFull timeWork from home
$174.07k - $374.92k
...Full-Time Utilization Management Physician Reviewer We're building a world of health around... ...passionate colleagues who care deeply, innovate with purpose... ...and prioritize safety and quality in everything we do. Join... ...Health Location: Remote/ Treehouse Role Description...Remote workQualityHourly payFull time- 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 jobFull time
- ChenMed is hiring a Physician Reviewer for Utilization Management to oversee delegated UM cases across multiple markets, supporting... ...and local teams. You will participate in care coordination and contribute to ongoing quality initiatives within our expanding organization...QualityLocal area
- ...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... ...confidentialityProvides quality assurance and education...Remote workQualityMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$248.5k - $373k
...Medical Director For Utilization ManagementWellMed,... ...family medicine physician to join our... ...is a clinician-led care organization that... ...flexibility to work remotely from anywhere within... ...processesParticipates in case review and medical... ...quality assurance and education...Remote workQualityMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- ...to join our dynamic team of expert reviewers! In this role, you will have the opportunity to utilize your medical expertise to conduct... ...and dedication to improving patient care. Your expertise is vital to helping us deliver high-quality healthcare assessments. #J-18808-...Remote workQualityFor contractors
- 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
- ...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
- ...mandated turnaround times. Our reviewers are compensated on a per-case... ...contractor. JOB SUMMARY As a Physician Reviewer/Advisor for Disability Peer Review, you will utilize clinical expertise to review... ...extensively, and ensure the quality and timely delivery of all...Remote workQualityFor contractorsMonday to Friday
- ...Centene is seeking a Utilization Review Clinician to assess mental health and substance use care across the continuum. Two schedules are available, with 10-hour shifts... ...families, review plans, and collaborate with medical directors to improve care quality. #J-18808-Ljbffr...Remote workQualityShift work
- ...Certified Internal Medicine Physicians Dane Street, a certified "... ...Medical Exams (IME) and Peer Reviews. This opportunity allows you... ...Chicago Area JOB SUMMARY: Utilizes clinical expertise, and... ...identifying and responding to quality assurance issues, complaints,...Remote workQualityFor contractorsMonday to Friday
- ...Umpqua Health is seeking an Utilization Review Clinician to perform clinical... ...use services. This remote role may require on-site travel... .... The URC collaborates with care management teams to ensure appropriate... ...to guidelines, and timely quality improvement. Strong clinical...Remote workQualityFull time
$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$155 - $165 per hour
...poster from EPITEC As a Physician Reviewer, you'll play a critical... ...our members receive high-quality, cost-effective care. You'll work closely with... ...Experience with managed care and utilization management ~ Strong... ...What We Offer Fully remote work arrangement (...Remote workQualityFull timeContract workWork at officeWeekend work- 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
- ...features. Location: Remote (Must reside in IL, MT,... ...experienced, board-certified physicians to join their Medicare Utilization Management team as Physician Reviewers. In this remote role,... ...teams to ensure quality and cost-effective care for our members. This position...Remote workQualityFull timeWeekend work
- ChenMed is seeking a licensed Physician Reviewer in Pain Management to support Utilization Management across remote PRN assignments. The role focuses on reviewing cases, coordinating... ...with health plans, and contributing to quality initiatives. You will operate across...Remote jobQualityRelief
- ...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
- ...staff position, please review this tip sheet. The... ...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 workQualityFull timeTemporary workWork at officeWorldwide
- 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
- 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
- ...Managed Medical Review Organization (MMRO... ...States to deliver high-quality, clinically sound,... ...practicing physicians. MMRO is committed... ...Reviews are conducted remotely and do not require... ...turnaround times. Utilize MMRO review... ...providing direct patient care. Active...Remote workQualityFull timeTemporary workFor contractorsFlexible hours
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