Remote Physician Reviewer - Utilization Management
ChenMed
- Remote job
ChenMed is seeking a Physician Reviewer to lead utilization management reviews and advise fellow physicians. The role includes coordinating care with health plans and local teams, participating in QA and delegated UM processes, and supporting territory-based case development. Strong analytical skills, English fluency, and MS Office proficiency are essential. Qualified candidates are MDs with Internal Medicine or Family Practice training, board certification, and hospital medicine experience #J-18808-Ljbffr ChenMed
- ...IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The role involves reviewing medical necessity... ...a collaborative environment with opportunities to leverage clinical expertise in utilization management. #J-18808-Ljbffr...Remote work
- 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
- ...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
$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 work- ...Full-Time Utilization Management Physician Reviewer We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate...Remote workFull time
- ...Role Overview Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient... ...escalate complex cases requiring physician review or additional intervention... ...Flexible work solutions include remote options, hybrid work schedules, competitive...Remote workMonday to FridayFlexible hoursWeekend work
$204.76k - $292.52k
...we need great people to join our team. The Physician Reviewer is the primary physician reviewer for Utilization Management (UM) cases in our organization. Other duties... ...site, please click HERE Current Contingent Worker please see job aid HERE to apply #LI-RemoteRemote workHourly payFull timeReliefWork at officeLocal area- 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
- ...integrating, and monitoring the utilization of behavioral health (BH... ...Medical Director for review and works closely with Case Management to address member needs.... ...with the treating physician or other providers of care... ...may be opportunity for remote work within all jobs posted...Remote workContract workWork at office
$248.5k - $373k
...internal medicine or family medicine physician to join our Utilization Management team. Optum is a clinician-led... ...'ll enjoy the flexibility to work remotely * from anywhere within the U.S. as... ...determination processesParticipates in case review and medical necessity...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$240k
Utilization Management Physician (UMP) Remote | Full-Time | Florida Compensation: $240,000 base + bonus Schedule: 40 hours/week Work Model: Remote (on-site... ...Management Physician to perform medical necessity reviews, peer-to-peer discussions, and clinical determinations...Remote jobFull timeRelocation- ...leading healthcare organization is seeking a RCS-Physician Advisor to join their Denial Management team. This full-time remote position requires a medical degree and board... ...to help optimize hospital services and resource utilization. #J-18808-Ljbffr Indiana University HealthRemote jobFull time
- ...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... ...schedule. The URC collaborates with care management teams to ensure appropriate level of...Remote workFull time
- ...Summary: We are seeking a highly experienced DRG Clinical Physician Reviewer to join our growing clinical review team. This is a fully remote opportunity for a physician with a strong background in utilization review and clinical validation who thrives in a fast-paced...Remote work
- ...job and more exclusive features. Location: Remote (Must reside in IL, MT, NM, OK, TN, or TX) Position... ...is seeking experienced, board-certified physicians to join their Medicare Utilization Management team as Physician Reviewers. In this remote role, you will review...Remote workFull timeWeekend work
$42.18 - $51.56 per hour
...healthcare? Bring your true colors to blue. The Physical Therapy Utilization Management Reviewer is responsible for evaluating the appropriateness and... ...Test. Interact with treating providers, PCPs, physicians, therapists, and facilities as needed to gather clinical...Hourly payFull timeWork at officeFlexible hoursShift work- ...Medical Reviewer Pay rate is ***/hour fully remote, but must reside in one of our plan states: IL, TX, NM, OK,... ...organization. Identifies opportunities to manage members' clinical situations with... ...managers. Participates in the Physician Review Units' appeal process of...Remote workMonday to FridayShift workWeekend work
- ...Beyond Blue Job Posting Title: Utilization Management Reviewer Requisition Number: R-000002878 Department Name: Supervisor, Utilization Review... ...secure certifications and authorizations. Coordinates with physicians, care teams, and ancillary staff to support effective...Full timePart timeWork experience placementReliefInternshipShift work
- ..., and adults as well as outpatient services such as medication management, case management, and counseling. Job Summary Mental Health Resource Center is looking for a Utilization Management Reviewer to monitor the utilization of clinical services provided at Mental...Full timeWork at officeMonday to FridayFlexible hours
$32 per hour
...an ongoing need for Document Reviewers. Document Reviewers will review... ...litigation! Position Details Remote work-from-home opportunity... ...is required. Proficiency in utilizing modern technology, especially... ...investigation and data recovery and management needs of our clients. Serving...Remote workHourly payTemporary workWork from homeHome officeMonday to ThursdayFlexible hours$87k - $115k
...Utilities Right of Way Document Specialist Manager - Texas - (1790) Location : Texas (candidate will have the flexibility to work out of their home office but... ...and other documents within approved systems. Review documents to prepare reports detailing ownership information...Daily paidFull timeWork from homeRelocationHome office- ...established industry player is seeking a Remote Physician Reviewer for a 3-year contract role. This... ...evaluating clinical service requests, utilizing clinical judgment to adjudicate requests... .... You will play a crucial role in managing members' clinical situations through...Remote jobContract work
- A leading Independent Review Organization is seeking a Board-Certified Physical... ...Rehabilitation provider to perform Utilization Reviews. This fully remote role offers flexible scheduling and... ...Certification. Apply to join our Physician Review Panel and start earning based...Remote jobExtra incomeFlexible hours
- ...Job Description Job Description Physician Peer Reviewer – Multiple Specialties in Texas and/... ...Review Organization (IRO) with Health Utilization Management (HUM) accreditation. For the past 30... ...external reviews Job Type Contract Work Location Remote...Remote workContract workWork experience placementWork at office
$65k - $88.6k
Humana is seeking a Behavioral Health Utilization Management professional to support clinical reviews for prior authorizations. The role requires IL-licensed clinicians... ...health and utilization review processes. Remote work with occasional travel to Humana offices is...Remote jobWeekly pay$50 per hour
...and Jack Dorsey . Position: Energy/Utilities — Visual Document Understanding Type:... ...Compensation: $50/hour Location: Remote Commitment: 15–20 hours/week Role... ...-truth outputs and objective rubrics. Review and improve AI model outputs to ensure...Remote workContract workSummer work- ...A leading payment management solutions provider seeks an Offsite Invoice Payment Specialist to manage utility invoice entries in a work-from-home setup. The role requires high typing speed and self-motivation along with the ability to work independently. Candidates must...Remote workWork from home
$35 - $37 per hour
...Lead RN Reviewer Cohere's Service Operations team is responsible... ...~5+ years in healthcare, managed care, or insurance-related roles... ...license (BSN preferred) ~ Utilization Management experience required... ...leadership style suited for a remote, fast-paced environment...Remote workHourly payFlexible hours$7.5k
...LPN Licensed Practical Nurse - Utilization Mgmt Reviewer - Case Management - Full Time Cortland, NY, United States Job Description This position is eligible... ...with Care Coordination, Guthrie Clinic offices, other physician offices, and the Robert Packer Hospital Business...Full timeWork at officeRelocation packageShift work- ...CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home role in the EST time zone. The position... ...license and hospital experience. Responsibilities include reviewing medical necessity, coordinating with providers, and ensuring...Remote workWork from home
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