Remote Utilization Management Physician Reviewer
ExamWorks UM Strategies
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 conducting thorough reviews of utilization management cases, collaborating closely with the Medical Director and other stakeholders, and ensuring compliance with medical guidelines. The role offers a structured schedule from Monday to Friday with occasional weekend work required. #J-18808-Ljbffr
- ...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...Remote workFull timeWork from home
- ...certified "Great Place to Work" company is seeking a Physician to provide utilization review services for the Group Health Department. This role... ...business background required Experience in Utilization Management with criteria review utilizing standard practice...Remote 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 Internal... ...in hospital medicine, with utilization review experience preferred. You will coordinate with...Remote job
- 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
- 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 workFor contractorsMonday to FridayFlexible hours
- ...Dual Occupational Medicine/Pain Management, Dual Internal Medicine/Pain... ...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...Remote workFor contractorsMonday to Friday
$204.76k - $292.52k
...Physician Reviewer We're unique. You should be, too. We're changing lives every day. For both our patients and our team members... ...Physician Reviewer is the primary physician reviewer for Utilization Management (UM) cases in our organization. Other duties include advising...Remote workHourly payFull timeWork at officeLocal area$86k - $117.3k
...For roles that are 100% remote or hybrid, you must have access... ...most. We offer integrated managed care products,... ...direction of a supervisor, the Utilization Management Reviewer evaluates medical necessity... ...escalate complex cases requiring physician review or additional...Remote workHourly payContract workMonday to FridayFlexible hoursWeekend work- ...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
- ...Beyond Blue Job Posting Title: Utilization Management Reviewer Requisition Number: R-000002878 Department Name: Supervisor... ...certifications and authorizations. • Coordinates with physicians, care teams, and ancillary staff to support effective...Remote workFull timePart timeReliefInternshipShift work
- ...Specialty Health System (StarCare) is seeking a full time Utilization Management (UM) Reviewer to join its outstanding Utilization Management team... ...will work in a hybrid work environment (combination of remote and on-site) and must be able to work on-site when job duties...Remote workFull timeWork at officeMonday to Friday
- ...ChenMed in Miami, Florida is seeking a Physician Reviewer to lead Utilization Management reviews, advise other physician reviewers, and coordinate care with health plans and local teams to support patient outcomes. The role emphasizes process and quality improvement...Local area
- tango is a leader in the home health management industry and is preparing for significant... ...care. We are currently looking for a Physician Reviewer to join our growing team on a full... ...peer discussions and education across utilization management, provider relations, and clinical...Remote jobFull time
- ezURs is seeking board-certified Pain Management Physicians for fully remote Physician Consultant positions. As a URAC accredited Independent Review Organization, our physicians perform utilization reviews, disability, and peer reviews across multiple lines of business....Remote jobFor contractors
- 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...Remote jobFull timeFlexible hours
- ...nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers. We are... ...Certification to conduct Utilization Reviews. This is a fully remote, non-clinical role... ...portal and streamlined case management Full onboarding and ongoing...Remote workPrice workExtra incomeFor contractorsFlexible hours
$130 - $145 per hour
...Hi, we're Oscar. We're hiring a Behavioral Health Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company... ...Management. Work Location: This position is fully remote and open to candidates residing in the U.S.,...Remote workHourly payFull timePart timeWork from homeHome office- ChenMed is seeking a Physician Reviewer to lead Utilization Management reviews for seniors in a rapidly expanding, physician-led organization. Based in Florida, you will support delegated UM cases, participate in health-plan and local calls, and contribute to process and...Local area
- ChenMed seeks a Physician Reviewer to lead Delegated Utilization Management across multiple markets. You will participate in health plan calls, coordinate patient care with local teams, and contribute to process improvements in the rapidly expanding UM function. Requirements...Local area
- ChenMed is seeking a Physician Reviewer to serve as the primary reviewer for Utilization Management (UM) cases across the assigned markets. You will advise other physician reviewers and participate in daily health plan calls to coordinate care for patients. This role supports...Local area
- ChenMed in Florida seeks a Physician Reviewer to lead Utilization Management reviews and coordinate care with health plan teams for multiple markets. You must hold a medical license with board certification and possess experience in hospital medicine or utilization review...Local area
- ...integrating, and monitoring the utilization of behavioral health (... ...Medical Director for review. Refer to and work closely with Case Management to address member needs... ...with the treating physician or other providers of... ...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:... ...Utilization Management Physician to perform medical necessity reviews, peer-to-peer discussions, and clinical...Remote workFull timeRelocation$248.5k - $373k
...internal medicine or family medicine physician to join our Utilization Management team. Optum is a clinician-led... ...processes Participates in case review and medical necessity determination... ...fluency *All employees working remotely will be required to adhere to...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- ...About MMRO Managed Medical Review Organization (MMRO) is a nationally recognized... ...of experienced practicing physicians. MMRO is committed to... ...questions. Reviews are conducted remotely and do not require direct... ...turnaround times. Utilize MMRO review templates and ensure...Remote jobFull timeContract workFor contractorsFlexible hours
- ...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
- ChenMed is transforming healthcare for seniors and expanding rapidly to help more patients. The Physician Reviewer leads delegated utilization management, supports health plan calls, and coordinates care with local teams. You’ll participate in QA initiatives to improve...Local area
- ChenMed is seeking a Physician Reviewer to lead Utilization Management (UM) reviews across assigned markets and coordinate care for our patients. You will cover delegated UM, attend health plan and local calls, and participate in quality improvement within our growing UM...Local area
- ...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 workContract work
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