Remote Utilization Management Physician Reviewer
Oak Street Health
Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to ensure medically appropriate coverage determinations for inpatient and outpatient services by applying UM criteria and clinical judgment. You will coordinate with internal and external teams to support optimal patient care and adhere to CMS and MCG guidelines. The role requires 1+ year UM experience with Medicare/Medicaid, an MD or DO, 3–5 years in primary care, US work authorization, and a patient-centered #J-18808-Ljbffr
Vacancy posted 2 days ago
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Lincoln, NE2 days ago - ...Oak Street Health seeks a Full-Time Utilization Management Physician Reviewer to determine inpatient and outpatient coverage using UM criteria and clinical judgment. You will coordinate with internal and external teams to ensure medically appropriate care is provided,...Remote workFull time
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San Diego, CA2 days ago - ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide accurate coverage determinations for inpatient and outpatient services. You will apply UM criteria with clinical judgment, coordinate with care teams, and ensure medically appropriate...Remote workFull time
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Las Vegas, NV2 days ago - ...Oak Street Health is seeking a full-time Utilization Management Physician Reviewer for a remote role. You will review requests, apply UM criteria, and coordinate with care teams to ensure appropriate care is provided in the right setting. Candidates should have MD/DO...Remote workFull time
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Harahan, LA2 days ago - ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide timely coverage determinations for inpatient and outpatient... ...by applying UM criteria and clinical judgment. This remote role collaborates with Transitional Care and PCP teams...Remote workFull time
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Orlando, FL2 days ago - ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide coverage determinations for inpatient and outpatient services... ..., clinical judgment, and internal policies. This remote role collaborates with care teams to ensure medically appropriate...Remote workFull time
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Memphis, TN2 days ago - IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The role involves reviewing medical necessity... ...offers a collaborative environment with opportunities to leverage clinical expertise in utilization management. #J-18808-LjbffrRemote work
IntePros
New York, NY3 days ago $174.07k - $374.92k
...Street Health in the United States is seeking a full-time Utilization Management Physician Reviewer to provide accurate and timely coverage determinations... ...applying UM criteria and clinical judgment. Working remotely, you will collaborate with care teams, stay current...Remote workWeekly payFull timeOak Street Health
Tucson, AZ2 days ago- ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide accurate coverage determinations for inpatient and outpatient services, leveraging UM criteria, clinical judgment, and internal policies. The role emphasizes coordination with...Remote workFull time
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Columbia, SC2 days ago - ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide timely coverage determinations for inpatient and outpatient... ..., and Medicare/Medicaid UM experience are required. Remote work option, standard full-time hours, and a comprehensive...Remote workFull time
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Dayton, OH2 days ago - ...Oak Street Health seeks a Full-Time Utilization Management Physician Reviewer to provide timely coverage determinations for inpatient and outpatient services using UM criteria and clinical judgment. You will coordinate with care teams to ensure medically appropriate care...Remote workFull time
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Sacramento, CA2 days ago - A healthcare management organization is seeking experienced Physician Reviewers to join their Medicare Utilization Management team in a remote position. Responsibilities include reviewing clinical service requests, applying evidence-based guidelines, and collaborating to...Remote work
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New York, NY3 days ago - ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to ensure accurate coverage determinations for inpatient and outpatient... ...a license to practice in the US. This position offers remote work options and competitive compensation packages,...Remote workFull time
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Springfield, IL4 days ago - ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provision accurate and timely coverage determinations for inpatient and outpatient services by applying UM criteria, clinical judgment, and internal policies. You will coordinate with...Remote workFull time
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San Francisco, CA2 days ago - ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide accurate coverage determinations for inpatient and outpatient services using UM criteria and clinical judgment. You will collaborate with PCP teams, stay current with CMS and...Remote workFull time
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Little Rock, AR2 days ago - ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provision accurate coverage determinations for inpatient and outpatient services, applying UM criteria and clinical judgments. This role requires collaboration with internal teams to...Remote workFull time
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Lexington, KY2 days ago - ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to determine coverage for inpatient and outpatient services using UM... ...Medicaid, strong communication, and US work authorization. Anticipated 40-hour weeks; remote work option. #J-18808-Ljbffr...Remote workFull time
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Santa Clara, CA2 days ago - ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provision accurate and timely coverage determinations for inpatient and outpatient services by applying UM criteria, clinical judgment, and internal policies. The role requires collaboration...Remote workFull time
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Savannah, GA2 days ago - ...Oak Street Health is seeking a full-time Utilization Management Physician Reviewer to provide timely coverage decisions for inpatient and outpatient services... ...patient-centered care. The position offers a remote work setup, competitive benefits, and opportunities to...Remote workFull time
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Virginia Beach, VA2 days ago - ...Oak Street Health is seeking a full-time Utilization Management Physician Reviewer to determine coverage for inpatient and outpatient services using UM... ...settings, while aligning with CMS and internal policies. This remote position offers a competitive salary range and...Remote workFull time
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Bakersfield, CA2 days ago - ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer. This physician will determine inpatient/outpatient coverage using UM criteria, clinical judgment, and internal policies to ensure medically appropriate care. Collaboration with care teams...Remote workFull time
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Oakland, CA2 days ago - ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to deliver accurate coverage determinations for inpatient and outpatient... ..., and support quality improvement initiatives while working in a remote, patient-centered #J-18808-Ljbffr...Remote workFull time
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Kansas City, MO2 days ago - ...Oak Street Health seeks a Full-Time Utilization Management Physician Reviewer to determine coverage for inpatient and outpatient services. The role relies on UM criteria, clinical judgment, and internal policies to recommend medically appropriate care, coordinating with...Remote workFull time
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Chicago, IL2 days ago - ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide timely coverage determinations for inpatient and outpatient... ..., and 3–5 years in primary care. The position offers a remote work setup with a focus on regulatory compliance and...Remote workFull time
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Greensboro, NC2 days ago - ...Oak Street Health is hiring a Full-Time Utilization Management Physician Reviewer for a Remote/ Treehouse role. You will determine coverage for inpatient and outpatient services using UM criteria, clinical judgment, and internal policies, coordinating with care teams...Remote workFull time
Oak Street Health
Cedar Rapids, IA2 days ago $130 - $145 per hour
...Hi, we’re Oscar. We’re hiring a part-time Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built around... ...Management. Work Location This is a remote position, open to candidates who reside in the United...Remote workHourly payFull timePart timeLocal areaWork from homeHome officeWeekend workOscar Health
New York, NY5 hours ago$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,... ...information and applying evidence-based guidelines. This remote role in the United States offers work from home with...Remote jobWork from home- Oak Street Health in the United States is seeking a Full-Time Utilization Management Physician Reviewer to provide coverage determinations for inpatient and outpatient services using UM criteria and clinical judgment. You will collaborate with Transitional Care and PCP...Remote jobFull time
- Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer. This remote role focuses on timely coverage determinations for inpatient and outpatient services using UM criteria and clinical judgment. Collaboration with care teams and adherence to...Remote jobFull time
- Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide timely UM determinations for inpatient and outpatient services, applying clinical judgment and evidence-based criteria to ensure medically appropriate care. The role requires US...Remote jobFull time
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