Remote Physician Reviewer — Utilization & Quality Oversight
tango
- Remote job
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 peer-to-peer discussions with payers and physicians to determine medical necessity for home health services. You will collaborate with provider relations and clinical management to support quality improvement, ensure regulatory compliance, and educate clinicians across the network while working from a flexible, #J-18808-Ljbffr tango
- ...a certified "Great Place to Work" company is seeking a Physician to provide utilization review services for the Group Health Department. This role... ...cases on or before the due date and time. Assist with quality assurance of reports prior to submission to clients....Remote workQuality
$219k - $286.9k
...Physician Reviewer - Utilization Management Hi, we're Oscar. We're hiring a Physician Reviewer to join... ...Management. Work Location: This is a remote position, open to candidates who... ...reviews that meet Oscar's stringent quality parameters. Provide clinical determinations...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 DPM degree with active board certification... ...to work from home while contributing to quality medical reviews. #J-18808-Ljbffr ExamWorksRemote jobQualityFull timeWork from home
$174.07k - $374.92k
...Full-Time Utilization Management Physician Reviewer We're building a world of health around every individual... ...accountable and prioritize safety and quality in everything we do. Join us and be... ...: Oak Street Health Location: Remote/ Treehouse Role Description:...Remote workQualityHourly payFull time- ...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
- ...management organization is seeking experienced Physician Reviewers to join their Medicare Utilization Management team in a remote position. Responsibilities include reviewing... ...guidelines, and collaborating to ensure quality care for members. Candidates must be board-certified...Remote jobQuality
- ChenMed LLC is seeking a Physician Reviewer to lead delegated utilization management (UM) reviews across multiple markets. You will establish daily case counts... ...reviewers, and participate in ongoing process and quality improvements. A strong medical background with...Remote jobQuality
$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... ..., evaluation, and oversight of the behavioral health...Remote workQualityHourly payPart timeWork from homeHome office- ...highly experienced DRG Clinical Physician Reviewer to join our growing... ...review team. This is a fully remote opportunity for a physician with a strong background in utilization review and clinical validation... ...directly impact healthcare quality and reimbursement integrity....Remote workQuality
- ...Street wants you to join our dynamic team of expert reviewers! In this role, you will have the opportunity to utilize your medical expertise to conduct thorough... ...Your expertise is vital to helping us deliver high-quality healthcare assessments. Requirements ~ Board...Remote workQualityFor contractors
- ...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
$204.76k - $292.52k
...Physician Reviewer We're unique. You should be, too. We're changing lives every day. For... ...is the primary physician reviewer for Utilization Management (UM) cases in our organization... ...will also participate in Process and Quality improvement in our developing area of...Remote workQualityHourly payFull timeWork at officeLocal area- ...Expert in Staffing APP’s and Physicians. The organization is a... ...outpatient, and pharmacy services by reviewing clinical information and... ...alignment with established quality standards. Make clinical determinations... ...Associate Medical Director, Utilization Management. Requirements...Remote jobQualityWeekend work
- ...Role Overview Our Utilization Management Reviewers evaluate medical necessity for... ...established turnaround times, quality benchmarks, and efficiency... ...complex cases requiring physician review or additional... ...Flexible work solutions include remote options, hybrid work...Remote workQualityMonday to FridayFlexible hoursWeekend work
- PHYSICIAN REVIEWER Independent Medical Review | Remote Opportunity Organization : Christopher Place Healthcare Review... ...physicians to contribute to healthcare quality and appropriate medical decision... ...Experience performing utilization review, peer review, independent...Remote jobQualityFlexible hoursWeekend workWeekday work
- 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... ...behavioral health, and familiarity with utilization review. #J-18808-Ljbffr Comagine HealthRemote jobQuality
- 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
- Umpqua Health is seeking an Utilization Review Clinician to perform clinical reviews for mental health and substance use services. This remote role may require on-site travel to Roseburg,... ...adherence to guidelines, and timely quality improvement. Strong clinical knowledge...Remote jobQualityFull time
$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$86k - $117.3k
...For roles that are 100% remote or hybrid, you must have access... ...of a supervisor, the Utilization Management Reviewer evaluates medical necessity... ...escalate complex cases requiring physician review or additional... ...metrics, turnaround times, and quality standards in a high-volume...Remote workQualityHourly payContract workMonday to FridayFlexible hoursWeekend work- 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
$155 - $165 per hour
...job poster from EPITEC As a Physician Reviewer, you'll play a critical role... ...that our members receive high-quality, cost-effective care. You'll... ...with managed care and utilization management Strong leadership... ...activities What We Offer Fully remote work arrangement (Weekends only...Remote workQualityFull timeContract workWork at officeWeekend work- Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide accurate coverage determinations for inpatient and outpatient services, applying UM criteria, clinical judgment, and internal policies. You will coordinate with care teams to ensure...Remote jobFull time
- ...are currently looking for a Physician Reviewer to join our growing team on... ...Physician Reviewer is in a utilization management reviewer role at... ...and support. Office Location Remote - flexible hours Essential... ...services. Reviews Potential Quality Issues (PQIs). The Physician...Remote jobQualityFull timeWork at officeLocal areaWork from homeFlexible hours
- ...exclusive features. Location: Remote (Must reside in IL, MT, NM,... ..., board-certified physicians to join their Medicare Utilization Management team as Physician Reviewers. In this remote role, you will... ...with internal teams to ensure quality and cost-effective care for...Remote workQualityFull timeWeekend 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 jobFull timeCasual workMonday to Friday
- 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
- ChenMed is hiring a Physician Reviewer for Utilization Management to oversee delegated UM cases across multiple markets, supporting health plan calls... ...in care coordination and contribute to ongoing quality initiatives within our expanding organization. The role...QualityLocal area
- ChenMed is seeking a Physician Reviewer to lead Utilization Management reviews for seniors in a rapidly expanding, physician-led organization. Based... ...health-plan and local calls, and contribute to process and quality improvements. Applicants should be graduates of an...QualityLocal area
- ...Description Job Description Remote but must be able to get to... ...is responsible for conducting quality audits for state audits,... ...1. Conducts on-site/virtual reviews at participating provider offices... ...assess environment, quality of physicians medical records, and...Remote workQuality
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Physician Reviewer — Utilization & Quality Oversight. Be the first to apply!
- doctor work from home Phoenix, AZ
- ent physician Phoenix, AZ
- smile doctors Phoenix, AZ
- sound physicians Phoenix, AZ
- physician medical doctor Phoenix, AZ
- resident doctor Phoenix, AZ
- physician-geriatric medicine Phoenix, AZ
- doctor of optometry Phoenix, AZ
- drug safety physician Phoenix, AZ
- permanent doctor Phoenix, AZ



