Remote Utilization Management Physician Advisor
E2E Alignment Healthcare USA, LLC
E2E Alignment Healthcare USA, LLC is hiring a Utilization Management Physician Advisor to optimize inpatient and outpatient services. The role involves conducting medical necessity reviews and leading utilization management strategies while serving as a clinical leader. Applicants should have a medical degree, experience in clinical or quality management, and strong communication skills. This role offers the flexibility of a remote position, ideal for dedicated professionals looking to make a significant impact in healthcare. #J-18808-Ljbffr
$80.17 - $119.26 per hour
CommonSpirit Health is seeking a System Physician Advisor to conduct clinical case reviews in a remote capacity. This role entails ensuring effective utilization of healthcare services, communicating with medical staff, and making recommendations regarding patient care....Remote jobHourly pay$331.41k - $373.44k
...Wapa is seeking a Physician Advisor to provide leadership within Utilization Management. This fully remote position supports Washington ministries, enhancing medical necessity practices and optimizing patient flow through data-driven strategies. Ideal candidates are...Remote work$198.22k - $297.33k
...Position Overview The Physician Advisor works with Senior Medical Officers, Regional Medical... ...a liaison between the medical staff, utilization review and 3rd party payers to effectively... ...Team to develop case management protocols and provide oversight for NP...Remote work- Pacificmedicalcenters is looking for a Physician Advisor to enhance physician leadership within Utilization Management. This remote role supports Washington ministries and aims to advance medical necessity practices, reduce denials, and improve patient flow. Applicants...Remote job
- Swedish is seeking a Physician Advisor to lead within Utilization Management, collaborating closely with Care Management and Medical Staff. This fully remote position supports Washington ministries and emphasizes advanced medical necessity practices, reducing preventable...Remote job
$331.41k - $373.44k
Swedish Medical Group is seeking a Physician Advisor for a fully remote position supporting Washington ministries. This role involves providing physician leadership within Utilization Management to improve patient flow and reduce preventable denials. The Physician Advisor...Remote job- ...are met. Currently employed physician(s) in VA who met the requirements... ...Community (CITC) using lean management principles to measure... ...safety quality standards and utilization management for the Care in the... ...as a vital resource and advisor for programmatic - clinical...Full timeContract workFreelanceInternshipLocal areaMonday to Friday
$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...- ...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
- ...Job Posting: Medical Director – Utilization Management (Remote) Pay: up to $200 an hour Position: Medical Director – Utilization Management Location... ...the professional autonomy and structural balance many physicians look for when transitioning to payer-side role s.Seamless...Remote workFull timeContract work
- ...A leading health insurance company is hiring a remote Physician Reviewer to join their Utilization Management team. This role involves determining the medical appropriateness of services based on clinical information and evidence-based guidelines. Candidates should have...Remote 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
$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 time$250k - $410k
...The Academy of Managed Care Pharmacy seeks an Associate Medical Director, Physician Advisor to provide clinical oversight in Utilization Management. This role collaborates with medical staff and leadership to optimize patient care while ensuring compliance with CMS regulations...- ...Review Organization (IRO) and leading provider of Utilization Review (UR) services, is expanding its panel of physician reviewers. We are currently seeking Board-... ...license to perform Utilization Reviews on a flexible, remote basis. This is a non-clinical, contract...Remote workExtra incomeContract workFor contractorsFlexible hours
- ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to ensure accurate coverage determinations for inpatient and outpatient... ...a license to practice in the US. This position offers remote work options and competitive compensation packages,...Remote workFull time
$240k
...Job Description Job Description Utilization Management Physician (UMP) Remote | Full-Time | Florida Compensation: $240,000 base + bonus Schedule: 40 hours/week Work Model: Remote (on-site meetings in Daytona Beach, FL ) Overview Seeking an experienced...Remote jobFull timeRelocation- ...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
- 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 jobFull time
- ...are seeking a high‑performing Physician Reviewer to join our Group... ...delivering timely, defensible utilization review determinations across... ...specific requirements. Ability 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
- ...Orthopedic Surgeon Utilization Review Opportunity Dane Street, a... ..., is expanding its panel of Physician Reviewers. We are currently... ...Reviews. This is a fully remote, non-clinical role offering... ...portal and streamlined case management Full onboarding and ongoing...Remote workPrice workExtra incomeFor contractorsFlexible hours
$26.01 - $62.32 per hour
4062 Aetna Resources, LLC is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) to work remotely. The role involves reviewing clinical information and coordinating treatment plans to ensure quality care. Candidates must have an active RN license...Remote workHourly payFull timeAfternoon shift- ...Job Description Job Description Vivo HealthStaff is recruiting for a Utilization Review Physician based in New York for a Managed Care Insurance Plan. This position requires 4 days per month on-site. The Utilization Review Physician is the lead clinician for the...Remote job
$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 job- ...Physician Advisor The Physician Advisor (PA) is a key member of the hospital's leadership... ...for ensuring the effective, efficient utilization of health care services. The PA will develop... ..., level of care progression, denial management and compliance with governmental...
- Corewell Health is expanding its Care Management team and is seeking a collaborative and clinically driven Physician Advisor to support our East Region. Position Overview... ...the intersection of clinical operations and utilization management. Physician Advisors are...Full timeMonday to FridayShift workWeekend work
$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... ...together. You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some...Remote jobMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- ...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 job
- ChenMed is looking for a Licensed Physician Reviewer - Ortho for a remote role based in Miami, FL. This position involves conducting Utilization Management reviews and advising other physician reviewers while participating in quality improvement efforts. The ideal candidate...Remote job
$211.2k - $277.2k
...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
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