State Licensed Utilization Reviewer
Virtual Vocations Inc
Working remotely, the full-time State Licensed Utilization Reviewer will perform utilization reviews on workers' compensation treatment referrals, ensuring the appropriateness of medical treatment plans and contributing to effective claims management. Key responsibilities Utilizes clinical judgment to determine the medical necessity of treatment requests Collaborates with healthcare providers and stakeholders to gather information for comprehensive assessments Communicates findings through written reports and verbal discussions while staying updated on industry regulations and best practices Required qualifications Doctor of Chiropractic (DC) with a valid license in the state of practice Minimum of 2 years of clinical experience or an advanced degree without experience Knowledge of medical terminology, treatment modalities, and healthcare guidelines Analytical and critical thinking skills for effective decision-making Strong communication and interpersonal skills to liaise with diverse stakeholders
Vacancy posted 3 days ago
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...your true colors to blue. The Physical Therapy Utilization Management Reviewer is responsible for evaluating the... ...appropriate to position (PT). Licensure in additional states a plus. Note: Any restrictions against a license must be disclosed and reviewed. Credentials:...SuggestedHourly payFull timeWork at officeFlexible hoursShift work$5,834 - $8,307 per month
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Utilities Right of Way Document Specialist - St. Charles, MO paid time... ..., 401(k) United States, Missouri, St. Charles Mar 0... ...conducting market data studies. Review and check documentation for accuracy... ...'s systems Valid Driver's License Bonus Points if you have experience...Hourly payFull timeWork experience placementWork from homeRelocationHome office- ...integrating, and monitoring the utilization of behavioral health (BH) or... ...to the Medical Director for review. Refer to and work closely... ...contractual benefits as well as State and Federal Mandates. May... ...Associates degree and active NYS RN license required. Bachelors degree...Contract workWork at office
- ...nationally recognized Independent Review Organization (IRO), is... ...with an active New York medical license and Workers' Compensation Board Certification to conduct Utilization Reviews. This is a fully remote... ...of services Utilize state-specific workers' compensation...Price workExtra incomeFor contractorsRemote workFlexible hours
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$130 - $145 per hour
...We’re hiring a part-time Physician Reviewer to join our Utilization Management team. Oscar is the first... ...candidates who reside in the United States. While your daily work will be completed... ...certification as an MD or DO. Licensed in one of these states: FL, NC, AZ OR...Hourly payFull timePart timeLocal areaRemote workWork from homeHome officeWeekend work$7.5k
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$91.7k - $163.7k
...benefit coverage determinations.Services reviewed may include, but are not limited to, the... ...Traditional outpatient psychotherapy visits State-specific Medicaid services (Psychosocial... ...tough challenges. Candidates must be licensed in the state of Kentucky but DO NOT need...Minimum wageFull timeWork experience placementWork at officeLocal areaRemote workWork from homeMonday to Friday- ...Qualifications Required: Graduate of an accredited school of nursing; Licensed to practice as a Registered Nurse in South Carolina; Three... ...degree in health-related field; Two years experience as Utilization Reviewer/Care Coordinator or Clinical Documentation Specialist with...
Self Regional Healthcare
Hodges, SC2 days ago - Umpqua Health is seeking an Utilization Review Clinician to perform clinical reviews for mental health and substance use services. This remote... ..., and timely quality improvement. Strong clinical knowledge and licensing in BH are essential. #J-18808-Ljbffr Umpqua HealthRemote jobFull time
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...Utilities Right of Way Document Specialist Manager - Texas - (1790) Location : Texas (candidate... ...documents within approved systems. Review documents to prepare reports detailing ownership... ...to access ORC’s systems. Valid Driver’s License. Bonus Points if you have a legal...Daily paidFull timeWork from homeRelocationHome officeO.R. Colan Associates
Wausau, WI2 days ago$204.76k - $292.52k
...great people to join our team. The Physician Reviewer is the primary physician reviewer for Utilization Management (UM) cases in our organization. Other duties... ...Medical School with a valid, unrestricted license is required Completion of Internal Medicine or...Hourly payFull timeReliefWork at officeLocal areaRemote workChenMed
Miami, FL48 minutes ago- ChenMed is seeking a Physician Reviewer to lead Utilization Management cases across multiple markets. The role covers delegated UM duties, coordination... ...patient care. A medical degree, active unrestricted license, and Internal Medicine/Family Practice residency are required...Local area
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$219k - $286.9k
Oscar Health is hiring a Physician Reviewer to join our Utilization Management team. You will determine the medical appropriateness of inpatient, outpatient... ...-based guidelines. This remote role in the United States offers work from home with occasional travel for meetings...Remote jobWork from home- ChenMed is seeking a Physician Reviewer to lead Utilization Management reviews for seniors in a rapidly expanding, physician-led organization. Based... ...be graduates of an accredited medical school with a valid license and residency in Internal Medicine or Family Practice. #J...Local area
- Dane Street is an Independent Review Organization and a national provider of Utilization Review services (among other offerings) and we are expanding our physician... ...specialties listed below with active Louisiana License to address the medical necessity of treatment...Extra incomeContract workRemote work
$174.07k - $374.92k
...time. Company: Oak Street Health Title: Utilization Management Physician Reviewer Location: Fully Remote Hours: full... ...skills ~ A current, clinical, unrestricted license to practice medicine in the United States. (NCQA Standard) ~ Graduate of an...Hourly payFull timeLocal areaRemote workMonday to Friday$90k - $110k
...environmental company in the United States for three consecutive years,... ...management system (DMS), utilizing Procore as the primary... ...receipt and submission through review, approval, distribution, and... ...circumstances.Required Certification/Licenses/Training: Professional...Full timeWork experience placementFor subcontractorFlexible hours$107.28k - $185.06k
...5Position Title:Psychologist Reviewer Senior - ABAJob Description:Work... ...appropriate and consistent utilization of plan benefits, out of... ...clinical guidelines within scope of license.Conducts pre-certification,... ...protected by federal, state, and local pay equity laws. *...Full timeTemporary workWork experience placementLocal areaDay shift1 day per week- ...Reviewer - Therapy Services Location: Virtual: This role enables... ...Current active unrestricted license or certification as a... ...pathologist assistant in applicable state required. Certification... ...Capabilities , and Experiences: Utilization Management and/or Skilled...Full timeContract workTemporary workLocal areaWeekend work1 day per week
Elevance Health
Grand Prairie, TX4 days ago $60.52k - $129.62k
...Position Summary The Care Plan Reviewer (Clinical Case Manager BH) utilizes advanced clinical judgment and... ...Unencumbered Behavioral Health clinical license in Ohio is required (LMFT, LSW, LPC... ...• Willing and able to travel in-state up to 10% of the time with a personal...Hourly payFull timeTemporary workLocal areaCVS Health
United States1 day ago
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