Remote Utilization Management Physician Reviewer
CVS Health
Oak Street Health is seeking a Utilization Management Physician Reviewer for a fully remote, full-time role. You will render timely coverage determinations for inpatient and outpatient services using UM criteria and clinical judgment, coordinating with care teams to ensure appropriate care. The role requires an active MD/DO license in the United States, 1+ year UM experience, and a strong understanding of managed care and CMS guidelines. Competitive pay and comprehensive benefits are offered. #J-18808-Ljbffr
$275k
...Job Description Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company... ...Utilization Management. Work Location: This is a remote position, open to candidates who reside in the United...Remote workFull timeLocal areaWork from homeHome officeWeekend work$275k
...Oscar Health is hiring a Physician Reviewer to join our Utilization Management team. The role is remote for candidates in the United States, with standard business hours and a weekend rotation. You’ll report to the Associate Medical Director, Utilization Management...Remote workWeekend 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
- ...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
- ...ChenMed is seeking a Physician Reviewer for Utilization Management to oversee UM cases and coordinate care across markets. You will participate in daily... ...medicine experience, and utilization review exposure. Remote work options and strong compensation are offered. #J-1...Remote work
- ...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
- ...Medix Staffing Solutions, Inc. is seeking a Physician Reviewer to join our Utilization Management team. This remote role evaluates medical necessity and clinical appropriateness across inpatient, outpatient, and pharmacy services by reviewing records and applying evidence...Remote work
$220k - $275k
...0000 - USD275000 per year + +Benefits Location: Remote- Must have NC or FL license OR IMLCC Schedule: Full... ...We are seeking a qualified and detail-oriented Physician Reviewer to join our Utilization Management team. In this role, you will evaluate the medical necessity...Remote workFull timeCurrently hiringLocal areaMonday to Friday$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$250k - $275k
Location: 100% Remote (Work from Home) Compensation... ...Are you an experienced physician seeking a high-impact,... ...a Remote Physician Reviewer to join our clinical team... ...guidelines to daily utilization reviews. Perform peer-... ...Review (UR) / Utilization Management (UM) experience within...Remote jobFull timeWork from home$275k
Oscar Health, Inc. is seeking a Physician Reviewer to join our Utilization Management team. You will assess medical necessity for hospital, outpatient, and pharmacy... ...services based on evidence-based guidelines. This remote role supports candidates in the United States. The...Remote job- 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
- 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
- ...professionals, which includes renowned physician advisors, senior nurse... ...entities, we focus on medical management, quality, compliance,... .... Role Description This is a remote contract role for a Utilization Management Physician Reviewer. Responsibilities include conducting...Remote workContract work
- Medix Staffing Solutions, Inc. is seeking a Remote Physician Reviewer to join our clinical team. You will evaluate the medical necessity and clinical appropriateness of inpatient, outpatient, and pharmacy services, leveraging evidence-based guidelines to drive high-quality...Remote jobFull time
$75k - $90k
...process. Clinical Reviewer - LCSW, LPC, LCPC - Salem... ..., Oregon OR Care Management F-T Reg 40 hrs Salaried... ...Annually This is a remote position based in... ...evidence-based criteria to utilization management reviews;... ...systems Consult with physician or practitioner reviewers...Remote workFull timeContract workWork from home$204.76k - $292.52k
...we need great people to join our team. The Physician Reviewer is the primary physician reviewer for Utilization Management (UM) cases in our organization. Other duties... ...site, please click HERE Current Contingent Worker please see job aid HERE to apply #LI-RemoteRemote workHourly payFull timeWork at officeLocal area- ...Independent Contractor (1099) Remote Opportunity Required... ...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
$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- ...Sentara Health Plans is seeking an RN Clinician for a remote role focused on utilization management and claim review. The position requires an active RN license (VA or Compact) and a BSN, with at least 3 years of acute care experience, including utilization review or...Remote work
- ...Physician Reviewer Opportunity Dane Street, a nationally recognized Independent... ...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
- ...Excellus BCBS in New York is seeking a Utilization Management professional to coordinate the use of physical health services for members, applying clinical criteria and policies to determine care appropriateness. You will collaborate with Case Management, providers...Remote work
$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- ...Sentara Health Plans seeks a Clinical Claims Reviewer RN for remote work. You will perform utilization management, review pre/post payment claims and authorizations for inpatient/outpatient cases, and address provider inquiries with appropriate referrals to Medical Directors...Remote workFull time
$62.4k - $117.62k
...integrating, and monitoring the utilization of physical health (PH)... ...Medical Director for review. Refer to and work closely with Case Management to address member needs... ...with the treating physician or other providers of... ...may be opportunity for remote work within all jobs posted...Remote workFull timeContract workWork at office- ...certified “Great Place to Work” company is seeking a Physician to provide utilization review services for the Group Health Department. This role requires... ...background required Experience in Utilization Management with criteria review utilizing standard practice guidelines...
- ...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 work
- ...to join our dynamic team of expert reviewers! In this role, you will have the opportunity to utilize your medical expertise to conduct... ...by our clients. We are looking for Physicians in the following area: Internal Medicine/Pain Management Be a part of a team that values...Remote workFor contractors
- ...Dane Street is an Independent Review Organization and a national provider of Utilization Review services (among other offerings... ...) and we are expanding our physician panel resulting in... ...services. Specialties PM&R/Pain Management The average time spent on most...Remote workExtra incomeContract work
- ...Oak Street Health is seeking a full-time Utilization Management Physician Reviewer to determine inpatient and outpatient coverage using UM criteria, clinical judgment, and internal policies. This role requires coordination with care teams to ensure appropriate care and...Remote workFull time
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