Senior Physician Reviewer - Utilization Management (Remote)
$219k - $286.9kOscar Health
Oscar Health seeks a Physician Reviewer to join the Utilization Management team. You will assess medical appropriateness for inpatient, outpatient, and pharmacy services by reviewing clinical data and applying evidence-based guidelines. This remote position, open to candidates nationwide in the United States, reports to the Associate Medical Director. The base pay ranged from $219,000 to $286,902 per year, with benefits, unlimited vacation, and annual bonuses. #J-18808-Ljbffr
- ...Oscar Health is seeking a Physician Reviewer for our Utilization Management team. You will assess medical appropriateness for inpatient, outpatient, and pharmacy... ...services using evidence-based guidelines. This is a remote position open to US residents. Typical hours are 8...Remote workSeniorLocal areaWeekend work
- ...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
$219k - $286.9k
...Remote 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. We started Oscar in 2012 to...Remote workFull timeFor contractorsLocal areaWork from homeRelocationHome officeWeekend work- ...Oak Street Health is seeking a Utilization Management Physician Reviewer for a fully remote, full-time role. You will apply UM criteria and clinical judgment to determine coverage for inpatient and outpatient services, coordinating with care teams to ensure appropriate...Remote workFull time
$230k
...care one person, one family and one community at a time. Company: Oak Street Health Title: Utilization Management Physician Reviewer Location: Fully Remote Hours: full time, Monday - Friday, 8am -5pm Salary: $230k per year Role Description:...Remote workHourly payFull timeLocal areaMonday to Friday- Ladders seeks a Utilization Management Physician Reviewer to join a leader in healthcare. This remote role evaluates service requests, applying evidence-based criteria and collaborating with care teams to ensure appropriate care delivery. The position emphasizes staying...Remote job
- Oscar Health is seeking a Physician Reviewer for its Utilization Management team. This remote role supports determining medical appropriateness for inpatient, outpatient, and pharmacy services, with a focus on evidence-based guidelines and clear documentation. You will...Remote jobWeekend work
- Oscar Health seeks a Physician Reviewer to join the Utilization Management team in a remote US-based role. You will determine the medical appropriateness of services and document decisions using evidence-based guidelines and Oscar workflows. Responsibilities include timely...Remote job
- 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...Remote jobFull timeCasual workMonday to Friday
- ExamWorks is seeking a Board Certified physician (Family Medicine or Internal Medicine) to join as a Utilization Management Physician Reviewer in a full-time, 100% remote role. The schedule is Monday through Friday, 8:30am-5:00pm, with occasional weekend/holiday coverage...Remote jobFull timeMonday to Friday
- ...In this remote contract role, the physician reviews clinical service requests from members and providers, applying clinical judgment and managed care criteria to determine appropriate care. The work... .... Preferred Experience in utilization review, case review, or related...Remote workFull timeContract workWeekend workWeekday work
- ...Acentra Health is seeking a Psychiatrist Physician Reviewer to provide leadership in peer review and utilization activities. The role involves phone consultations with... ...-Service beneficiaries. Position is PRN and remote within Illinois. The ideal candidate is...Remote workRelief
- ...Independent Contractor (1099) Remote Opportunity Required State... ...Founded in 1983, Medical Review Institute of America (MRIoA... ...specializing in technology-driven utilization management and clinical medical review... ...seeking Board-Certified physicians in Dermatology to conduct...Remote workFor contractorsFlexible hours
- ...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 workFor contractors
- ...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
- 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
- ...Sentara Health Plans is hiring a Clinical Claims Reviewer/RN for a remote role. This full-time position involves utilization management and post-payment review across various care settings, with RN licensure and coding credentials under consideration. The role offers...Remote workFull time
$52 - $56 per hour
...apply the same medical necessity judgment you built in utilization management. 100% remote (U.S.) | Contract | $52–$56/hr based on experience... ...and appeals end to end: intake, investigation, clinical review, decision and notification Apply medical necessity...Remote workContract workAfternoon shift- ...recognized Independent Review Organization (IRO), is... ...its panel of Physician Reviewers. Key Responsibilities... ...necessity of services Utilize state-specific workers... ...income Fully remote - work from anywhere You... ...and streamlined case management Full onboarding and ongoing...Remote workPrice workExtra incomeFor contractors
$35 - $40 per hour
...Sagility LLC, a leader in healthcare transformation, seeks an RN Utilization Management Reviewer for a fully remote role. You will perform timely clinical decision reviews for services requiring prior authorization across various clinical areas, applying criteria like...Remote workHourly pay$204.76k - $292.52k
...people to join our team. The Physician Reviewer is the primary physician reviewer for Utilization Management (UM) cases in our... ...transforming healthcare for seniors and changing America’s healthcare... ...Current Contingent Worker please see job aid HERE to apply #LI-RemoteRemote workHourly payFull timeWork at officeLocal area- ...The Physician Advisor Lead at HURC provides clinical leadership, mentorship, and quality... ...production workload. In this senior role, you will partner with HURC leadership... ...determinations, P2P performance, and utilization management outcomes, while guiding onboarding and...Remote workSenior
- ...Integrated Management Strategies, LLC is seeking an experienced Sr Review Coordinator for our healthcare consulting practice. This fully remote role within the United States focuses on utilization review of plans of service for home and community-based programs, supporting...Remote workSeniorWork from home
- ...Sentara Health Plans is seeking an RN Clinician for remote utilization management and claims review. You will perform pre/post payment reviews, authorizations, and post-payment inquiries in a compliant manner with NCQA, CMS, DMAS guidelines. Requires a BSN and 3 years...Remote work
$130 - $145 per hour
...States 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., excluding...Remote workHourly payFull timePart timeFor contractorsWork from homeRelocationHome office- ...Cook Children's Health Care System is seeking a Registered Nurse Utilization Management/Episodic Case Manager (UM/ECM - RN) Reviewer to coordinate the efficient utilization of health care resources for CCHP members and ensure timely, quality care throughout the continuum...Remote work
- ...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... ...’s mission to transform healthcare for seniors through quality improvement and collaboration...Local area
- ...System team, and The Power of Every One. Job Title Utilization Management RN Reviewer Location Cleveland Facility Remote Location Department Utilization And Quality... ...denials appeals process, clinical team interaction, Physician Adviser interaction and special projects. A...Remote workFull timeWork at officeShift workWeekend work
- ...Providence California Regional Services is seeking a Senior Utilization Management Assistant for a remote Per Diem role. The 8-hour day shifts provide support within the Care Management team to coordinate patient care. You will work under the supervision of the Regional...Remote workSeniorDaily paidDay shift
- ...Prime Therapeutics invites a Senior Clinical Specialist Pharmacist to join our team remotely in the United States. This role focuses on delivering clinical... ..., handling prior authorization and utilization management, and supporting claims adjudication alongside...Remote workSenior
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