Remote Utilization Management Physician
CVS Health
Oak Street Health seeks a Utilization Management Physician Reviewer to ensure timely coverage determinations for inpatient and outpatient services using UM criteria and clinical judgment. The role collaborates with internal teams to promote quality care, adherence to CMS/MCG guidelines, and regulatory compliance. The ideal candidate is board-certified with an unrestricted US license, 3–5 years in primary care, and a strong foundation in managed care and patient advocacy.
#J-18808-Ljbffr$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 home$219k - $286.9k
...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... ...Utilization Management. Work Location: This is a remote position, open to candidates who reside in the...Remote workFull timeLocal areaWork from homeHome officeWeekend 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 jobFull timeWork from home
- ...a certified “Great Place to Work” company is seeking a Physician to provide utilization review services for the Group Health Department. This... ...business background required Experience in Utilization Management with criteria review utilizing standard practice...Remote work
$230k
...health 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 CST Salary: $230k per year Role Description...Remote workHourly payFull timeLocal areaMonday to Friday- Oak Street Health is seeking a Utilization Management Physician Reviewer to determine inpatient and outpatient coverage using UM criteria and clinical judgment. You will coordinate with care teams to ensure appropriate care, while aligning with CMS guidelines and organizational...Remote job
- 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 jobContract work
- ...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
- ...Internal Medicine) looking for a full-time, remote job in a nonclinical setting? \n \n... ...! \n \n ExamWorks is seeking a physician board-certified in either Family... ...Medicine to join the team full-time as a Utilization Management Physician Reviewer. \n \n This...Remote workFull timeMonday to FridayWeekend 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 jobFull time
- 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
$219k - $286.9k
Oscar Health seeks a Physician Reviewer to join the Utilization Management team. You will assess medical appropriateness for inpatient, outpatient, and pharmacy... ...data and applying evidence-based guidelines. This remote position, open to candidates nationwide in the United...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
- 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
- ...professionals, which includes renowned physician advisors, senior nurse executives,... ...entities, we focus on medical management, quality, compliance, accreditation... ...practices. Role Description This is a remote contract role for a Utilization Management Physician Reviewer....Remote workContract work
$213.1k - $383.58k
...respect for the people and communities we serve. The Job The Utilization Management (UM) Physician Medical Director provides physician-level clinical... ...range: $213,100 to $383,580 per year Work Mode - Mostly Remote: Employees who reside outside the local area are...Remote workFor contractorsWork at officeLocal areaRelocation$250k
...Rate/Range: $250,000 to $500,000 Job Summary The Care Management & Utilization Management Physician Advisor is a physician leader who works across... ...Some administrative responsibilities may be performed remotely as appropriate. May require occasional travel to affiliated...Remote workLive inWork at officeShift work- ...Job Description Job Description Vivo HealthStaff is recruiting for a Utilization Review Physician based in New Jersey for a Managed Care Insurance Plan. This position requires 4 days per month on-site. The Utilization Review Physician is the lead clinician for...Remote work
- ...really matters, not only changing lives but saving them. Together. The Remote Regional Medical Director, Non-Acute Utilization Management (RMD Non-Acute UM) is a market-facing physician leader responsible for optimizing clinical outcomes, quality performance, utilization...Remote work
- ...Board Eligible Internal Medicine Physician Ochsner Health is seeking... ...to reduce call burden ~ Remote messaging Nurses to reduce in... ...the portal ~ Outpatient Care Managers to assist with complex... ...EPIC medical record platform utilized throughout the health system...Remote workRelocation packageFlexible hours
$272.69k - $373.8k
...center.Role SummaryThe Hospitalist Physician provides inpatient medical care to... ...support in person 7a-7p, eICU remote support from 7p-7aVent management support by critical care teamNocturnistShift... ...on staff availability currently utilizing in-house MD and APPs. Only as last...Remote workFull timeTemporary workShift work- ...Job Description Job Description We are seeking a Field Manager for utility access road construction and data mapping to become an integral part of our team! Days consisting of exploring remote access roads, managing field operations, using GIS technology, and supporting...Remote workFull timeWork at officeWork from homeFlexible hours
- ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant in the Baltimore area. The role leverages RN clinical... ...RN license, 3+ years experience, and MS Office proficiency; remote work options with home setup requirements; strong documentation...Remote workWork from home
$200k - $325k
...Virtual Primary Care Physician Firefly Health is building a revolutionary new type of... ...of care initiatives by supporting the management of high-complexity patients, promoting... ...evidence-based care, and guiding appropriate utilization across the care continuum...Remote workShift work- ...CVS Health is hiring a Medicare Precertification Utilization Management Nurse Consultant. The role involves assessing care options, applying clinical criteria, and coordinating with providers to ensure appropriate services are delivered. Requires RN licensure and 3...Remote workFull timeWork from homeMonday to Friday
$198k - $297k
...technology-enabled revenue cycle management solutions for health systems... ...hospitals and affiliated physician groups. They offer end-to-... ...a subject matter expert on utilization management (UM) issues. They... ...experimentation to scale. - This is a remote position; however,...Remote workFull timeTemporary workWork at officeLocal area$135k - $165k
...our success in ensuring our physicians and their patients get what they... ...need most. Location : Remote - United States Travel: up... ...this role matters): The Manager, Global Physician Network is... ...onboarding, readiness, availability, utilization, and ongoing participation....Remote workFull timeTemporary work- ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant to assess and coordinate healthcare services for members. The role emphasizes clinical judgment, collaboration with providers, and effective utilization management. Strong RN...Remote workWork at officeWork from homeAfternoon shift
- ..., seeks BC/BE Internal Medicine physicians to join our expanding Department... ...transform health care across the state utilizing a clinically integrated network,... ...of Digital Health services Remote Patient Monitoring for chronic disease management Centralized Call Center and...Remote workRelocationRelocation packageFlexible hours
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