Behavioral Health Utilization Reviewer & Payer Liaison
Department for Persons with Disabilities
The Department for Persons with Disabilities is seeking a full-time Utilization Review Coordinator based in Parsippany, NJ. This role involves securing payer authorizations for behavioral health services, ensuring compliance with medical necessity, and facilitating communication between clinical teams and insurance payers. Qualifications include 2–5+ years of relevant experience and a strong background in insurance authorization processes. The position offers a competitive hourly wage with various benefits including paid training, health insurance, and a 403B plan. #J-18808-Ljbffr Department for Persons with Disabilities
$150 - $170 per hour
...CareCentrix is seeking a Part-Time Physician Reviewer to conduct utilization reviews, ensuring medical necessity across various services. This role involves collaboration with internal staff and healthcare providers to support evidence-based care decisions. The ideal candidate...SuggestedHourly payPart timeFlexible hoursWeekday work- ...IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization... ...Medicine, preferably with experience in health insurance. This position offers a... ...with opportunities to leverage clinical expertise in utilization management. #J-18808-Ljbffr...SuggestedRemote work
$174.07k - $374.92k
...inpatient and outpatient services by applying utilization management (UM) criteria, clinical... ...the final determination, the Physician Reviewer is responsible for ensuring medically appropriate... ...to understand language per Oak Street Health policies and procedures and industry...SuggestedHourly payFull time- ...management organization is seeking experienced Physician Reviewers to join their Medicare Utilization Management team in a remote position. Responsibilities... .... A comprehensive benefits package including health plans and 401(k) is offered, promoting equality and diversity...SuggestedRemote 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...SuggestedFull timeCasual workRemote workMonday to Friday
- ...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 and unrestricted medical license in relevant states. The role involves performing detailed...Full timeRemote workWork from home
- ...Dane Street, a certified “Great Place to Work” company is seeking a Physician to provide utilization review services for the Group Health Department. This role requires utilizing clinical expertise to review medical records and provide an interpretation of the medical...
- ...Opportunity Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician... ...license and Workers' Compensation Board Certification to conduct Utilization Reviews. This is a fully remote, non-clinical role offering...Price workExtra incomeFor contractorsRemote workFlexible hours
- About Dane Street Dane Street is a leading Independent Review Organization (IRO) and national provider of Utilization Review services. As we continue to expand our physician panel, we’re offering flexible, remote opportunities for board-certified physicians seeking supplemental...Extra incomeFor contractorsRemote workFlexible hours
$86k - $154.7k
...apply for the Psychologist Reviewer role at RemoteWorker US... ...professional on our Medical Management/Health Services team. Centene is a... ...for improving access to behavioral health care? Centene is... ...as well as participating in Utilization Management clinical rounds....Full timeWork at officeRemote workRelocation packageFlexible hours- ...first 25 applicants Community Outreach Liaison (Behavioral Health/Business Development) Levittown, PA 1... ...client’s situation and requirements. Utilizes appropriate bonding techniques to... ...admitting physicians and utilization review coordinators. Builds a strategic regional...Full timeContract workLocal areaNight shift
$90k - $95k
...RN OASIS Reviewer The RN OASIS Reviewer is responsible for reviewing... ...OASIS assessment and home health coding knowledge base. 5.... ...Educates team members regarding all payer rules and regulations. 11.... ...quarterly chart audits and utilization review. 15. Serves on...$90k - $105k
...and experienced Physician Liaison to engage directly with... ...through sustained behavior change, including optimizing utilization of in‑network, high‑quality... ...virtual and in‑person) to review performance, co‑develop... ...administration, Nursing, Public Health, Business, or related...Local areaRemote workWork from homeFlexible hours$211.2k - $277.2k
...Job Description Job Description Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members....Full timeLocal areaRemote workWork from homeHome officeWeekend work- ...Integrated Services for Behavioral Health is hiring a Billing Specialist in Kentucky. This role focuses on Medicaid billing, ensuring accurate... .... This position is vital for handling client billing and revenue cycle operations across multiple payers. #J-18808-Ljbffr...
- ...therapy referrals and qualifying criteria by payer source, such as TPN, Enteral Nutrition... ...(i.e. hospital case managers, home health agencies, physician offices) and Mount Sinai... ...patients with a broad variety of diagnoses and behaviors on a daily basis. Ability to walk, stand,...Work at officeMonday to FridayShift work
- A leading Independent Review Organization is seeking a Board-Certified Physical Medicine and Rehabilitation provider to perform Utilization Reviews. This fully remote role offers flexible scheduling and supplemental income. Responsibilities include reviewing medical records...Extra incomeRemote workFlexible hours
$155 - $165 per hour
...the job poster from EPITEC As a Physician Reviewer, you'll play a critical role in ensuring... ...problems, ultimately driving better health outcomes for our members. Required Skills... ...experience Experience with managed care and utilization management Strong leadership and...Full timeContract workWork at officeRemote workWeekend work- ...MVP Health Care is seeking a remote Sub-Acute RN UM Reviewer to join its Utilization Management team. In this vital role, you will conduct clinical reviews ensuring compliance with Medicare guidelines and support high-quality patient outcomes. The role requires current...Remote work
$95 - $96 per hour
...Specialty Services, Inc is looking for a Family Medicine Physician specializing in imaging case reviews and appeals. This role requires a commitment to quality patient care and utilization management, ensuring compliance with URAC and NCQA standards. The ideal candidate will...Hourly pay- ...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, data...Remote work
- ...Overview Dane 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 reviews of clinical cases. This telework opportunity allows you to customize your schedule...For contractorsRemote work
$90k - $110k
...monitoring of technical site health and scaled AI content... ...the CSM serves as the liaison between the customer... ...assigned client, to review executive dashboards,... ...at all times and that behavior aligns with Conductor... ...adaptable, and skilled at utilizing AI to amplify their...Work experience placementLocal area- ...About Alpaca Health Alpaca Health is a business-in-a-box for autism care providers to... ...understand weekly billable hours and optimize utilization, scheduling, cancellations, etc.... ...role. An operator with experience in ABA, behavioral health, healthcare practice management,...Work at officeFlexible hoursWeekend workWeekday work
$140k - $165k
...lifecycle to our clients in biopharma, health insurance, digital health, medical devices... ...RFPs Strong knowledge and experience utilizing various data sources used in strategic consulting... ...about society, markets, brands, and behaviors to provide our clients with the insights...Flexible hours$60k - $90k
...About the Job Physician Liaison - Relationship & Outreach Specialist Location: Manhattan, NY (Field-Based + Office Time)... ...key insights back to our leadership. Leverage Technology: Utilize our CRM and referral tools to track visits, document interactions...Private practiceWork at office- ...Physician & Community Liaison Territory: New York City and Long... ...the 34 Most Promising Women's Health Startups of 2022, this is a rare... ...activities and opportunities, utilize dashboards & other reporting tools... ...requests will be subject to review and approval by Our Company,...Full timeWork experience placementWork at officeLocal areaWork from homeNight shiftWeekend work
- An established industry player is seeking a Remote Physician Reviewer for a 3-year contract role. This exciting opportunity involves evaluating clinical service requests, utilizing clinical judgment to adjudicate requests, and providing clinical leadership within the organization...Remote jobContract work
$100k - $120k
...American Endovascular is seeking a Physician Liaison. This role will be responsible for... ...business growth through effective strategies. Utilize an entrepreneurial mindset to develop and... ...01(k) Dental insurance Flexible schedule Health insurance Paid time off Vision insurance...Full timeLive inWork at officeFlexible hours- ...experienced, board-certified physicians to join their Medicare Utilization Management team as Physician Reviewers. In this remote role, you will review clinical... ...of gender. We are proud to offer five diverse health plan options as well as a PPO dental plan through Blue...Full timeRemote workWeekend work
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