Remote Urology Physician Clinical Reviewer
Prime Therapeutics
- Remote job
A leading pharmacy benefit manager is seeking a Physician Clinical Reviewer specializing in Urology to join their utilization management team remotely. The ideal candidate will have a DO, MBBS, or MD degree and over 5 years of clinical experience. Responsibilities include reviewing clinical cases and discussing determinations with physicians. This position offers a competitive pay range based on experience, ensuring compliance with medical guidelines while working within a diverse and inclusive company culture. #J-18808-Ljbffr Prime Therapeutics
$90.87 - $154.33 per hour
A leading pharmacy benefit manager is seeking a Physician Clinical Reviewer to join their utilization management team. This remote position requires a medical degree (MD, DO, MBBS) and at least 5 years of clinical experience. Responsibilities include reviewing medical...Remote job$90.87 - $154.33 per hour
A leading pharmacy benefit manager is seeking a Physician Clinical Reviewer specializing in Urology. This remote role involves medical review of service requests and requires a DO, MBBS, or MD degree along with at least 5 years of clinical experience. Candidates must ensure...Remote job$90.87 - $154.33 per hour
A healthcare organization is seeking a Physician Clinical Reviewer for a remote role. This position involves conducting medical reviews of service requests that do not meet medical necessity guidelines while interacting with physicians and leadership. The ideal candidate...Remote job$90.87 - $154.33 per hour
A leading pharmacy benefit manager is seeking a Physician Clinical Reviewer - Urology to join their utilization management team. The role involves medical... ...or MD and at least 5 years of clinical experience. This remote position offers a competitive salary range from $90.87...Remote job$90.87 - $154.33 per hour
A leading pharmacy benefit manager is seeking a Physician Clinical Reviewer - Urology for a remote position. The role involves reviewing complex clinical cases, providing rationales for medical necessity, and ensuring compliance with guidelines. Candidates must have a...Remote job$90.87 - $154.33 per hour
A nationwide pharmacy benefit management company based in Washington, DC is seeking a Physician Clinical Reviewer for a remote role focused on Urology. The ideal candidate should hold an MD, DO, or MBBS and have over 5 years of clinical experience. Responsibilities include...Remote job$90.87 - $154.33 per hour
A leading pharmacy benefit manager is seeking a Physician Clinical Reviewer specializing in Urology. This remote position involves reviewing clinical cases for medical necessity, ensuring timely communication with healthcare providers, and maintaining accurate documentation...Remote job$90.87 - $154.33 per hour
...Physician Clinical Reviewer - Urology- REMOTE Key member of the utilization management team, and provides timely medical review of service requests that do not initially meet the applicable medical necessity guidelines. Routinely interacts with physicians, leadership...Remote workWork at officeLocal areaVisa sponsorshipWork visa$90.87 - $154.33 per hour
...serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Physician Clinical Reviewer - Urology- REMOTE Job Description Job Description The Physician Clinical Reviewer is a key member of the utilization...Remote workWork experience placementInternshipWork at officeLocal areaVisa sponsorshipWork visa$90.87 - $154.33 per hour
Prime Therapeutics (Prime) is a purpose‑driven PBM seeking a Physician Clinical Reviewer - Urology (remote). This key member of the utilization management team provides timely medical review of service requests that do not initially meet medical necessity guidelines. The...Remote jobHourly payWork at officeLocal areaVisa sponsorshipWork visa- ...Description Job Summary The purpose of this position is to utilize clinical expertise to review medical records against established criteria in accordance with contract requirements. Location: Remote (U.S.-based) Licensure Requirement: Must hold an active clinical...Remote workContract workWork at officeMonday to FridayWeekend workWeekday work
- ...Clinical Reviewer Position Are you passionate about using your clinical expertise to support... ...determinations? We're recruiting for 2 full-time remote/hybrid Clinical Reviewer positions.... ...health care services. Consult with physician/practitioner consultants when reviews...Remote workFull timeWork from homeMonday to Friday
- ...Overview We are seeking a clinically trained physician to provide targeted review and validation of HEOR and real-world evidence (RWE) outputs. This role ensures analyses are interpreted through a real-world clinical lens and are aligned with Medical Affairs...Remote work
- ...Behavioral Health Services Reviewer Are you passionate about improving... ...? Do you enjoy using your clinical expertise to evaluate needs,... ...on this team. This is a remote position based in Oregon and... ...designated systems Consult with physician or practitioner reviewers...Remote workFull timeContract workWork from home
$81.22k - $121.83k
...(UM) Clinician is responsible for conducting benefit coverage reviews and utilization management according to applicable regulatory... ...opportunities to improve service, reduce administrative cost, ensure clinically appropriate delivery of benefit covered services, and support...Remote workContract workWork at officeWork from home$55 - $75 per hour
...Per Diem, Non-Exempt (Hourly) Location: Sacramento, CA (Remote/Hybrid) Compensation : $55-$75 per hour, depending on experience... ...Under the direction of the Associate Director, the Licensed Clinical Reviewer supports clinical documentation review and quality assurance...Remote workHourly payDaily paid10 hours per week- ...Clinical Documentation Reviewer This is a remote position. Position Overview We are seeking a Clinical Documentation Reviewer to support TUWYN's contract... ...involves participating in daily huddles with VA physicians and interdisciplinary teams, prioritizing reviews for...Remote workContract workPart timeFor contractorsMonday to Friday
$185 per hour
...compliant AI platform that unifies intake, clinical documentation, coding, and quality... ...~ ~3+ years in home-health QA/OASIS review, utilization review, or clinical documentation... ...in a fast-moving startup environment and remote collaboration tools. Reliability counts...Remote workContract workReliefShift workWeekend work$115.44k - $173.16k
...and/or specialty section regarding peer review, specialty specific studies and performance... ...activities. Collaborates with physicians in determining peer review indicators, what... ...responsibilities. Ability to multi-task. Job Title: Clinical Peer Reviewer Department:...Remote workFull timeWork at officeShift work$85k - $92k
...Job Title: CLINICAL QUALITY REVIEWER (RN or LCSW) Job ID: 87049 Location: USA- Remote in approved states Overview: We are partnering with a leading organization supporting a large-scale federal healthcare program to identify a Clinical Quality Reviewer. This role...Remote workHourly payWork at officeHome office- ...general supervision of the Associate Director, or designee, the Clinical Reviewer - PASRR is responsible for reviewing submitted referrals and... ...responsibilities. Environmental Working Conditions Remote position which requires working at computer for all tasks....Remote workWork experience placementWeekend work
$28.37 - $35 per hour
...empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that... ...Job Summary and Responsibilities Acentra seeks a Clinical Reviewer to join our growing team. Job Summary: The Clinical Reviewer...Remote workContract workWork at officeLocal areaMonday to FridayFlexible hoursShift workWeekend work- ...We are seeking a qualified SUD MD Reviewer to conduct a retrospective utilization... ...historically denied cases to determine if standard clinical criteria were appropriately applied.... ...Requirements Work is 100% remote and offers flexible hours. Benefits...Remote workTemporary workLocal areaFlexible hours
- ...Clinical Appeals Reviewer (Licensed Healthcare Professional) Fully Remote-United States Job Type Full-time Description Overview Tanaq Support Services (TSS) delivers professional, scientific, and technical services and information technology (IT) solutions...Remote workFull timeContract workPart timeFor contractorsWork at officeLocal areaNight shift
- ...employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following... ...Required Work Experience ~2 years of experience in clinical field of practice, health insurance, or other health care related...Remote workFull timeContract workWork experience placementWork at office1 day per week
$73.2k - $122k
...following: Laboratory molecular and genetic testing clinical case review activities. Evaluate telephone, fax, or web requests for... ...coverage of molecular and genetic laboratory requests from physician offices; comparing requests against established clinical protocols...Remote workLocal areaWork from homeFlexible hours$40 - $45 per hour
...Pay Range: $40 - $45 per hour based on experience Work Hours : 20 hours per week (Mon - Fri) Location : Remote Summary : The Clinical Reviewer is responsible for conducting clinical reviews of submitted prior authorization (PA) requests and pre-payment...Remote workHourly payPart timeFor contractorsWork at officeLocal area$90.87 - $154.33 per hour
A healthcare management organization is seeking a remote Physician Clinical Reviewer specialized in Pediatric Rheumatology. The role entails reviewing clinical cases where medical necessity isn't initially met, consulting with healthcare providers, and ensuring proper...Remote job- A leading healthcare service provider in the United States is looking for a Clinical Appeals Reviewer. This fully remote position involves reviewing appeal cases and making independent decisions based on medical evidence. Candidates must be licensed healthcare professionals...Remote job
$90.87 - $154.33 per hour
A leading pharmacy benefit manager is looking for a remote Physician Clinical Reviewer specializing in Pediatric Rheumatology. This role involves collaborating with physicians to review service requests and ensure compliance with medical necessity guidelines. Candidates...Remote job
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