Remote Physician Advisor: Utilization Management & Appeals
LADDERS
New York, NY
- Remote job
Client is seeking a Physician Advisor to join the Hospitals & Medical Centers space in a remote capacity. The role guides utilization management decisions supporting inpatient care, observation review, and medical necessity determinations. You will partner with medical staff, leadership, and payor medical directors to strengthen clinical collaboration and resolve coverage and appeals issues. This position supports quality, compliance, and efficient care delivery across the hospital setting, with #J-18808-Ljbffr Ladders
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Remote Physician Advisor: Utilization Management & Appeals in New York, NY vacancy
- ...Ensemble RCM is seeking a Physician Advisor in the United States to render compliant status... ...' medical directors. You will lead utilization management initiatives, educate staff, and attend... ...committees to support denials and appeals. The role emphasizes building strong...Remote work
Ensemble RCM
United States1 day ago - Ensemble Health Partners is seeking a Physician Advisor to render compliant statuses for... ...committees, and guiding denials and appeals. Remote position with occasional onsite travel... ...outcomes within healthcare revenue cycle management. #J-18808-Ljbffr Ensemble Health PartnersRemote job
$250k
...$500,000 Job Summary The Care Management & Utilization Management Physician Advisor is a physician leader who works across... ...in medical-necessity denials, appeals, and related escalation processes... ...may be performed remotely as appropriate. May require occasional...Remote workLive inWork at officeShift work2600 White Plains Hospital Medical Center
Nevada, IA3 days ago- Ensemble Health Partners is seeking a Physician Advisor to render compliant status determinations for hospitalized patients, conduct... ...medical directors, and serve as a subject matter expert on utilization management (UM) issues. The role reviews short inpatient stays and...Remote job
$150 per hour
...JobThe temporary Medicare Advantage Utilization Management (UM) Physician provides physician-level decision-making... ..., concurrent review, and appeals programs. This role serves as the clinical... ...$200.00 per hourWork Mode - Mostly Remote: Employees who reside outside the local...Remote workTemporary workPart timeFor contractorsWork at officeLocal areaRelocationScan-Health-Plan
Long Beach, CA1 day ago$150 per hour
...Job The temporary Medicare Advantage Utilization Management (UM) Physician provides physician-level decision-... ...authorization, concurrent review, and appeals programs. This role serves as the... ...0.00 per hour Work Mode - Mostly Remote: Employees who reside outside the local...Remote workHourly payTemporary workPart timeFor contractorsWork at officeLocal areaRelocationSHPCA SCAN Health Plan
California1 day ago- ...Place to Work” company is seeking a Physician to provide utilization review services for the Group Health... ...requests for Prior Authorizations and Appeals including medical records and make a... ...Experience in Utilization Management with criteria review utilizing standard...Remote work
Dane Street
United States2 days ago - ...research centers and institutes, experts collaborate to advance medicine through a shared mission and vision. Utilization Management is seeking a Physician Advisor-Lead to join their team! This full-time position will be instrumental in leading and building our enterprise...Full time
UF Health
Gainesville, FL4 days ago - ...) looking for a full-time, remote job in a nonclinical setting... ...n ExamWorks is seeking a physician board-certified in either... ...the team full-time as a Utilization Management Physician Reviewer. \n... ...quality work. \n Review appeals or complaints that relate to...Remote workFull timeMonday to FridayWeekend work
ExamWorks UM Strategies
West Virginia12 days ago - Penn Medicine, a leading academic medical center, seeks a Physician Advisor to provide clinical leadership within Utilization Management and to support appropriate patient status determinations, medical necessity review, and regulatory compliance. The role centers on clinical...
- White Plains Hospital in White Plains, NY is seeking an experienced Care Management & Utilization Management Physician Advisor to lead across Care Management, Utilization Management, CDI, Coding, Quality, and patient safety. The role focuses on ensuring appropriate utilization...
- RWJBarnabas Health in Livingston, NJ seeks a Physician Advisor to join Cooperman Barnabas Medical Center on a full-time, on-site... ...and corporate administration, medical staff, and case management to optimize utilization and care progression. The ideal candidate is Board...Full timeLocal area
$211.2k - $275k
...Location: 100% Remote (Must reside in an eligible U.S. state... ...seeking a board-certified physician to join a collaborative clinical... ...as a Physician Reviewer in Utilization Management . In this role, you will... ...requests, escalations, and appeals using evidence-based guidelines...Remote workLocal areaImmediate startHome officeMonday to FridayWeekend workMedix
New York, NY2 days ago- ...expanding its panel of Physician Reviewers. We are currently... ...to conduct Utilization Reviews. This is a fully remote, non-clinical role offering... ...treatment requests and appeals. No patient contact, no... ...portal and streamlined case management Full onboarding and ongoing...Remote workPrice workExtra incomeFor contractorsFlexible hours
- ...experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals for DMEPOS. You will collaborate with our Medical... ...those meeting criteria, and referring non-meeting cases. Remote opportunities available; competitive compensation and benefits...Remote work
Integra Partners
Springfield, IL12 hours ago - ...Integra Partners is seeking an LPN/LVN with managed care experience to perform pre-service and post-service utilization reviews and appeals for DMEPOS. You will collaborate with the Medical Director to conduct benefit and medical necessity reviews within an NCQA-compliant...Remote work
Integra Partners
Colorado12 hours ago - ...Integra Partners is seeking an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals in a managed care UM program. You will collaborate with the Medical Director to review benefit language, medical necessity, and appeals within NCQA...Remote work
Integra Partners
Michigan12 hours ago - ...experienced LPN/LVN to conduct pre-service and post-service utilization reviews and appeals within a NCQA-compliant UM program, collaborating with... ...responsibilities including approvals, referrals, and handling appeals. Remote opportunities available and strong team culture. #J-188...Remote work
Integra Partners
Ohio12 hours ago - ...Quorum Health Corporation is seeking a remote Utilization Review Specialist (Case Manager) to support admission decisions and appeals. The role requires an RN license and strong knowledge of criteria sets to support clinical appeals and quality reviews. Responsibilities...Remote workFull time
Quorum Health Corporation
Lexington, KY12 hours ago - ...Integra Partners is seeking an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals in a managed care UM program. This role collaborates with the Medical Director on benefit and medical necessity reviews, aligned with NCQA standards...Remote work
Integra Partners
Clifton, TX12 hours ago $248.5k - $373k
...businesses, is seeking an internal medicine or family medicine physician to join our Utilization Management team. Optum is a clinician-led care organization that... ...Growing together.You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from homeUnitedHealth Group
San Antonio, TX3 days ago- ...experienced LPN/LVN to conduct pre-service and post-service utilization reviews and appeals in a managed care environment. You will collaborate with our... ...of InterQual and CMS guidelines is preferred, and we offer remote work options and a comprehensive #J-18808-LjbffrRemote work
Integra Partners
Alton, IL12 hours ago - ...experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals for DMEPOS within a NCQA-compliant UM program. You will... ...at least 3 years of nursing experience and 2 years in managed care UM, and have knowledge of InterQual and CMS criteria...Remote work
Integra Partners
Atlanta, GA12 hours ago - ...practice, and we are looking for a Senior Utility Management Services (UMS) Consultant to help lead... ...toolkits. Serve as a trusted advisor to clients looking with fresh eyes at modern... ...This is a hybrid position (in office/remote). We offer a telecommute option to work...Remote workFull timeFor contractorsWork at officeLocal areaWork from homeWork visa1 day per week
Blue Cypress Consulting, LLC
Washington DC3 days ago $53 per hour
...Phaxis - Healthcare is hiring for a REMOTE RN opportunity focused on Grievance & Appeals and Utilization Review. The role requires candidates to reside in New York... ...direct outpatient UM experience, strong utilization management background, and experience with prior...Remote workLong term contractContract workMonday to FridayPhaxis - Healthcare
New York State12 hours ago$275k
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... ..., Utilization Management.Work Location: This is a remote position, open to candidates who reside in the United...Remote workFull timeLocal areaWork from homeHome officeWeekend workOscar Health Insurance
New York, NY3 days ago- ...Toney Healthcare is seeking a physician reviewer for a remote contract role in Utilization Management. This position focuses on evaluating medical necessity, appropriateness, and efficiency of services by reviewing medical records and applying established guidelines. Collaboration...Remote workContract work
Toney Healthcare
United States2 days ago $29.1 - $62.32 per hour
...CVS Health Remote Clinical Position We're building a world of health around every individual —... ...schedules will be determined in collaboration with management to ensure adequate weekend coverage. Position Summary: Utilize your clinical experience and skills in a...Remote workFull timeWork at officeWork from homeShift workWeekend workCVS Health
United States4 days ago$52 - $56 per hour
...Description Job Description You've done UM. You've worked appeals. Now find a role that uses both. We're hiring a... ...apply the same medical necessity judgment you built in utilization management. 100% remote (U.S.) | Contract | $52–$56/hr based on experience...Remote jobContract workAfternoon shiftPhaxis LLC
New York, NY13 days ago- ...Job Description Job Description Vivo HealthStaff is recruiting for a Utilization Review Physician based in New York for a Managed Care Insurance Plan. This position requires 4 days per month on-site. The Utilization Review Physician is the lead clinician for the...Remote job
Vivo HealthStaff
Carteret, NJ15 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Physician Advisor: Utilization Management & Appeals. Be the first to apply!
Related searches
- permanent primary care physician New York, NY
- full time post-acute physician New York, NY
- medical marijuana physician New York, NY
- obesity physician New York, NY
- supervising physician New York, NY
- physician reviewer New York, NY
- doctor on call New York, NY
- physician New York, NY
- physician-plastic surgery New York, NY
- physician-maternal-fetal medicine New York, NY