Remote Physician Advisor: Utilization Management
Alignment Healthcare
Alignment Healthcare is seeking a Physician Advisor to collaborate with the Senior Health Plan Medical Director on clinical reviews for hospital admissions. This role requires a minimum of 5 years of clinical experience, preferably in internal medicine, and a valid California Physician and Surgeon’s license. The position is part-time, remote, with occasional in-office meetings. Successful candidates will demonstrate strong knowledge of medical regulations and excellent communication skills, working effectively with medical staff and case managers to ensure appropriate levels of care. #J-18808-Ljbffr
Vacancy posted 4 days ago
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Shreveport, LA4 days ago - ...Full time Shift Description THIS IS A 1099 POSITION The Physician Advisor serves as a physician leader responsible for improving clinical... ..., case mix index (CMI), medical necessity compliance, utilization management, and hospital throughput. The Physician Advisor works...SuggestedFull timeLocal areaShift workNight shift
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Beverly Hills, CA4 days ago- ...Cedars-Sinai Medical Center is seeking an Associate Medical Director, Physician Advisor to support Utilization Management by providing clinical oversight and compliance guidance. The role involves collaboration with medical staff and hospital leadership to optimize patient...
Independent Educational Consultants Association
Beverly Hills, CA4 days ago - ...Physician Advisor Corewell Health is expanding its Utilization Management team and is seeking a collaborative and clinically driven Physician Advisor to support our East Region. Position Overview The Physician Advisor serves at the intersection of clinical operations...Weekend work
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Daytona Beach, FL17 days ago- ...Dane Street, LLC is seeking a remote Physician Reviewer for full-time work from home. The role requires an MD or DO, board-certified in Internal or Family Medicine, to perform utilization reviews, including preauthorization and appeals. Ideal candidates will have prior...Remote workFull timeWork from home
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New York, NY3 days ago - ...a clinical resource for hospitals and to resolve denials through peer-to-peer reviews. Qualified candidates must be licensed physicians with a minimum of 5 years of clinical practice experience and board certification in Internal Medicine or Family Medicine. The position...Remote workWork from home
Independent Educational Consultants Association
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...Beverly Hills, CA, United States Be the First to Apply Job Description Overview: The Associate Medical Director, Physician Advisor supports Utilization Management by providing clinical oversight, education, and guidance on medical necessity, Centers for Medicare and...Full timeContract workPart timeRelocation packageCedars-Sinai Medical Center
Beverly Hills, CA5 days ago- ...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
ExamWorks
New York, NY3 days ago - ...Greenkey Resources LLC is hiring a remote Clinical Reviewer based in Arizona. In this role, you'll review medical appropriateness... ...clinical determinations. If you hold an MD and have experience in utilization review, this position invites you to be part of a...Remote work
Green Key Resources
Tempe, AZ4 days ago - ...listed on behalf of a partner company, who manages all applications and next steps. Our... ...is looking for a Senior Business Analyst, Utility Process Consultant based in United States... ...work arrangements for eligible roles. Remote-friendly work environment with flexibility...Remote jobFull timeFlexible hours
jobgether
United States6 days ago - ...A healthcare services company is seeking a full-time remote Utilization Management Physician Reviewer. The role requires a board-certified physician to perform thorough reviews of utilization management cases ensuring high standards of patient care. Responsibilities include...Remote workFull time
ExamWorks
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Seattle, WA1 day ago- ...solutions provider in New Jersey is seeking a Physician Advisor to provide clinical guidance and... ...reviews. The candidate will support utilization review and ensure adherence to medical... ...skills and proficiency in utilization management are essential. This role offers a unique...Remote work
HURC Healthcare Solutions
Short Hills, NJ4 days ago - ...are seeking a high-performing Physician Reviewer to join our Group... ...delivering timely, defensible utilization review determinations across... ...specific requirementsAbility to manage short-TAT and urgent cases... ...operating systems Work Environment Remote work from home Full-time,...Remote workFull timeTemporary workWork at officeWork from homeMonday to FridayNight shift
Dane Street
New York, NY2 days ago - ...Job Posting: Medical Director – Utilization Management (Remote) Position: Medical Director – Utilization Management Location: Remote (Anywhere in... ...offers the professional autonomy and structural balance many physicians look for when transitioning to payer-side role s.Seamless...Remote workFull timeContract work
Medix
Syracuse, NY1 day ago $172.36k - $258.55k
A leading healthcare company is seeking a Physician Advisor for Utilization Management. The role requires a California license and significant experience in clinical care and utilization management. Responsibilities include processing reviews, liaising with medical staff...Remote workAlignment Healthcare
California, MO5 days ago- ...St. Joseph’s Health, Inc. is seeking a Physician Advisor in Paterson, New Jersey. The role entails overseeing patient care, optimizing resource... ...include conducting medical necessity reviews, managing denials and appeals, and collaborating with leadership to enhance...Monday to Friday
St. Joseph’s Healthcare System
Paterson, NJ5 days ago $174.07k - $374.92k
Oak Street Health, part of CVS Health, is seeking a Full-Time Utilization Management Physician Reviewer to ensure accurate coverage determinations for inpatient and outpatient services. This role requires at least one year of Utilization Management experience in Medicare...Remote workFull timeOak Street Health, part of CVS Health
Chicago, IL2 days ago- ...IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The role involves reviewing medical necessity... ...a collaborative environment with opportunities to leverage clinical expertise in utilization management. #J-18808-Ljbffr...Remote work
IntePros
New York, NY3 days ago - ...A leading healthcare facility in the United States seeks a Clinical Product Consultant for Utilization Management. The role involves providing clinical insights, ensuring product accuracy, and managing implementation milestones. Candidates should have a BSN, extensive...Remote workFlexible hours
Santa Barbara Cottage Hospital
New York, NY3 days ago - ...A healthcare management organization is seeking experienced Physician Reviewers to join their Medicare Utilization Management team in a remote position. Responsibilities include reviewing clinical service requests, applying evidence-based guidelines, and collaborating...Remote work
Solving IT
New York, NY3 days ago - 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
Dane Street
Washington DC5 days ago $250k - $410k
...Cedars-Sinai Medical Center in Beverly Hills is seeking an Associate Medical Director, Physician Advisor, to lead Utilization Management. This position involves ensuring compliance with medical necessity, guiding a team through complex case reviews, and enhancing care...Cedars-Sinai Medical Center
Beverly Hills, CA4 days ago- ...(IRO), is expanding its panel of Physician Reviewers. We are currently seeking... ...Board Certification to conduct Utilization Reviews. This is a fully remote, non-clinical role offering supplemental... ...portal and streamlined case management Full onboarding and ongoing...Remote workPrice workExtra incomeFor contractorsFlexible hours
Dane Street
New York, NY1 day ago - ...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 workFull timeCasual workMonday to Friday
ExamWorks UM Strategies
New York, NY3 days ago $211.2k - $277.2k
...Physician Reviewer - Utilization Management You will determine the medical appropriateness of inpatient, outpatient, and pharmacy services by reviewing... ..., 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
United States2 days ago
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