Clinical Review Physician - Utilization & Care Management
Kaiser Permanente
Kaiser Permanente is seeking a Clinical Reviewer to adjudicate coverage requests using established criteria and contract language. You will document decisions, communicate rationale, and work with regional leaders to ensure timely reviews. The role requires an MD or DO with residency in internal or family medicine, Washington license, and experience in utilization/quality management. Strong collaboration and communication are essential. #J-18808-Ljbffr Kaiser Permanente
- ...Group, a KP health plan partner, seeks a Clinical Reviewer to adjudicate coverage requests using... ...communications and collaborate with care managers to ensure appropriate levels of care... ...medicine residency; experience in utilization management and quality programs is preferred...Suggested
- JOB SUMMARY Clinical Reviewer Unit Physicians ensure that requests for coverage are adjudicated using... ...chiefs, individual physicians and care management related to clinical review outcome... ...hospital management, case management, utilization review, clinical pathways, and...SuggestedContract workImmediate startWeekend work
- ...Medical Group in Renton, WA seeks a Clinical Reviewer to adjudicate coverage requests using... ...regulatory timelines, and collaborating with care management teams. The role requires a medical... ...Washington licensure; knowledge of utilization management and quality programs is...Suggested
- ...Maternal Fetal Medicine Physician (MD/DO) | Full-Time Location... ...by strong system-wide clinical resources and multidisciplinary... ...comprehensive consultative and co-management care for high-risk pregnancies... ...and care planning • Utilize EPIC EMR for documentation and...SuggestedFull timeLocal area
$300k - $325k
...Virtual Primary Care Physician Firefly Health is building... ...and in-person clinical network, and our proprietary... ...in quality review activities, contributing... ...initiatives by supporting the management of high-complexity... ...guiding appropriate utilization across the care...SuggestedWork at officeRemote workShift work- ...patient-centered adult primary care, supported by seamless access... ...emphasizes chronic disease management, preventive care, complex patient... ...facilities, and robust clinical support. Position Summary... ...Board-Eligible Internal Medicine Physician to join its expanding...Permanent employmentFull time
- ...mandated turnaround times. Our reviewers are compensated on a per-... ...exams may be needed Job Summary Utilizes clinical expertise and reviews... ...and retrospective claims. The Physician Reviewer will provide an interpretation... ..., and standards of care. Major Duties and...Contract workFor contractors
- ...incumbent to provide patient care - direction -... ...and leadership in the management of Chronic Pain and Opioid... ...- therefore a clinical appointment at UW is included... .... Currently employed physician(s) in VA who met the requirements... ...- performing - reviewing - analyzing and...Full timeContract workTraineeshipFreelanceInternshipWork at officeLocal areaRemote workRelocation packageMonday to Friday
- ...Nutritional Care Duties Nutritional Care:... ...nutrition assessment utilizing the Nutrition Care Process... ...recovery from illness, management of chronic disease or... ...as a liaison between clinical units/wards and the food... ...measurable outcomes and reviews the plan, as...Permanent employmentRemote workRelocation packageMonday to Friday
- ...Position: Primary Care Physician (Family Medicine or Internal Medicine... ...preventive medicine, chronic disease management, wellness care, same-day... ...benefit from modern clinical spaces, coordinated support... ...ancillary services as needed Utilize evidence-based guidelines and...Permanent employmentFull time
- Occupational Medicine Clinical Consultant Location: US... ...occupational health care company. With more than... ...s medical model while utilizing the data and tools... ...coordination and claims management that contribute to extended... ...practices for Case Reviews and implement adoption...Local area
$70 - $97 per hour
...Become a part of our caring community As a... ...and periodic review of the Plan of Treatment... ...Plan of Care. Utilize professional... ...supervisor and/or the physician. Provide instruction... ...Certification of Clinical Competence in... ...care for patients managing a chronic condition...Full timeTemporary workApprenticeship$70 - $97 per hour
...Join Our Caring Community As a therapist... ...development and periodic review of the Plan of... ...Plan of Care. Utilize professional... ...supervisor and/or the physician. Provide instruction... ...Certification of Clinical Competence in... ...care for patients managing a chronic condition...Temporary work$300k - $330k
Requisition: 2026-0382 Physician - Sports Medicine (Renton, WA) | Full... ...Medicine Physician to join our area clinics in our collaborative network... ...patient-centered, team-based care to a diverse population of... ...Inclusion on Becker's Hospital Review's list of 153 Great Community...Full timeRelocation packageFlexible hours$275k - $325k
Job Description Position: Primary Care Attending Physician Location: Danbury, CT Schedule: Full-Time Salary: $275,000 - $325... ...telehealth primary care services. This role combines direct clinical care with quality management initiatives to optimize senior care. Key...Daily paidFull time$125 per hour
...our scalable solutions and clinical expertise help solve programmatic... ...to drive improvements in care delivery. After completion... ..., daily work includes reviewing and analyzing clinical records... ..., urology, or orthopedics. Utilization management experience preferred....Remote jobHourly payFull timeFor contractorsWork at officeLocal areaImmediate startWork from home- ...deep understanding of diagnostic reasoning, chronic disease management, and patient care will help ensure AI systems deliver accurate, empathetic,... ...reasoning. What You’ll Do: Design and solve advanced clinical scenarios reflecting internal or emergency medicine practice...Remote jobContract workFor contractorsFreelance
- ...Medicine, Division of Medical Genetics, seeks a full-time Assistant or Associate Professor on the Clinical Practice Track. The role is based at UW Medical Center to care for medical and biochemical genetics patients and to teach students and residents. Rank will be commensurate...Full time
- ...Description Job Description Primary Care Physician (Family Medicine) | Full-Time... ...across the lifespan • Diagnose and manage acute illnesses, chronic conditions... ...-based care model with dedicated clinical support staff • Utilize EPIC EMR and integrated population...Full timeWork at office
- ...Maternal–Fetal Medicine Physician (MFM Specialist) Location... ...and maintains strong clinical integration with a well-regarded... ...comprehensive obstetric care, high-risk pregnancy management, advanced maternal... ...quality initiatives, case reviews, and multidisciplinary team...Permanent employmentFull time
- ...Job Description Primary Care Physician (MD/DO) | Full-Time Location... ...patients across the lifespan • Manage acute and chronic conditions... ...healthcare providers • Utilize evidence-based medicine to... ...outpatient practice with strong clinical support and an emphasis on...Full time
$245.58k
...want to be part of a caring, respectful, diverse community... ...care. Supports clinical excellence through collaboration... ...or procedures. Review and document patient's... ...in developing and utilizing HealthPoint practice... ...being involved with risk management and utilization...Local areaShift work$324.58k - $381.86k
...to provide exceptional care - and our model is... ...Permanente Medical Group, our physicians benefit from... ...their patients. From managing follow-up instructions... ...care of many of the non-clinical responsibilities for you... ...further information, please review the Know Your Rights...Permanent employmentFull timeLocal area$295.3k - $347.41k
...geriatric fellowship trained physician(s) to join our clinic family at the Bellevue... ...to be part of an integrated care delivery system that prioritizes... ...clinical support to help manage patient needs & care... ...further information, please review the Know Your Rights notice...Full timePart timeLive inLocal areaImmediate startRelocation package$130 per hour
...committed to improving access to very high-quality mental health care! Each clinician is dedicated to evidence-based care and a... ...corporate administrative interference! Up to 240/hour clinical medication management, reimbursement organized per code, choice of 30 min or 20...Hourly payFull timeTemporary workWork from home$340k - $360k
...perfect time to join our clinical team! We are actively... ...about patient care and committed to clinical... ...PsychiatryExperienced in both medication management as well as therapy.... ..., our recruiters utilize email addresses with... ...as they will not be reviewed or responded to. To...Full timeWork at officeWeekend work$41.47 - $68.43 per hour
...Language Pathologist (Acute Care) - CCC Required (2023-0... ...descriptions are reviewed and revised to meet the... ...Speech Language Pathologist Clinical Resource JOB OVERVIEW:... ...REPORTS TO: Manager, designee - Supervisor... ...quality patient care. Utilize technology for communication...Daily paidFull timeInterim roleRelocation packageMonday to FridayShift workWeekend work$300k
...ophthalmic groups, offering excellent clinical support, state-of-the-art facilities... ...about who we are, our culture, our physician leadership, and the communities we... ..., we are known for our cutting-edge care, collaborative co-management model, and commitment to outstanding...Full timePart time$274.9k - $328.6k
...One Medical is a primary care solution challenging the industry... ...preventive care, chronic care management, common illnesses and mental... ...Continuous learning during weekly Clinical Rounds and through other... ...with virtual clinical teams Utilization of your specific clinical...Full timeTemporary workWork at officeRelocation package$274.9k - $328.6k
...One Medical is a primary care solution challenging the industry... ...preventive care, chronic care management, common illnesses and mental... ...Continuous learning during weekly Clinical Rounds and through other... ...with virtual clinical teams Utilization of your specific clinical...Full timeTemporary workWork at officeRelocation package
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