Average salary: $226,319 /yearly
More statsGet new jobs by email
$275k - $300k
...5,000-$300,000) Full benefits: health, vision, dental, vacation, CME, PTO Requires 5+ years experience in Medicare Advantage Utilization Review/Utilization Management and an active unrestricted CA license ASAPstart date Sacramento is the state's capital andhas over 450...SuggestedPermanent employmentFull timeRemote workWork from homeMonday to FridayIntegrity Healthcare
Sacramento, CA3 days ago- The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical records for the patient population and Hackensack UMC. These include but are not limited to utilization review...SuggestedDaily paidWeekend work
$174.07k - $374.92k
...helping to simplify health care one person, one family and one community at a time. Job Profile Summary The Utilization Management Physician Reviewer ensures timely and clinically sound coverage determinations for inpatient and outpatient services using evidence-...SuggestedHourly payFull timeLocal areaFlexible hoursWeekend workOak Street Health
Springfield, IL12 days ago- ...Utilization Review Surgery Nurse - RN Pascagoula Hospital | Full-Time | Monday-Friday rotating weekends/Holidays | 2809 Denny Ave Pascagoula, Mississippi United States Position Overview: The Case Manager focuses on clinical quality and resource...SuggestedFull timeWork at officeMonday to FridayShift workDay shift
Singing River Health System
Pascagoula, MS3 days ago $248.5k - $373k
...deliver clinical coverage and medical claims reviews. Our role is to empower providers and... ...costs. The Medical Director provides physician support to Enterprise Clinical Services... ...application of clinical knowledge in various utilization management activities with a focus on...SuggestedRemote jobMinimum wageWork experience placementLocal area- A leading medical review organization is seeking a Board-Certified Sports Medicine/Family Medicine physician for a remote Independent Contractor role. The physician will perform utilization review work, ensuring healthcare services are necessary and compliant. Responsibilities...SuggestedRemote jobFor contractors
- .... ABOUT MRIoA Founded in 1983, Medical Review Institute of America (MRIoA) is a nationally... ...(IRO) specializing in technology‑driven utilization management and clinical medical review... ...Sports Medicine/Family Medicine physician to assist in Utilization Review work, which...SuggestedFor contractorsRemote workWork from homeFlexible hours
- ...Physician Reviewer – Utilization Management (Remote)-Full Time Overview We are seeking a Board-Certified Physician to support utilization management activities by reviewing clinical documentation and determining the medical appropriateness of inpatient, outpatient, and...SuggestedFull timeLocal areaRemote workWeekend work
Medix
New York, NY5 days ago - ...Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers. We are currently seeking Board-... ...Workers’ Compensation Board Certification to conduct Utilization Reviews. This is a fully remote, non-clinical...SuggestedPrice workExtra incomeFor contractorsRemote workFlexible hours
Dane Street
United States1 day ago $28.41 - $43.47 per hour
...Prior Authorization (PA) Department Coordinate and execute the review and research functions required to support the PA Department... ...empower them. Providence Health Plan is calling an Associate Utilization Review Specialist who will: Be responsible for all core functions...SuggestedRemote jobMinimum wageFull timeWork experience placementShift work- A recognized Independent Review Organization is seeking a Board-Certified Psychiatrist for a fully remote role conducting Utilization Reviews. Candidates should have an active New York medical license and Workers’ Compensation Board Certification. Responsibilities include...SuggestedRemote jobExtra incomeFlexible hours
- Inova Fairfax Medical Campus is looking for a dedicated physician advisor to join the Utilization Review Advisor team. This role will be full‑time and on‑site. It is also available as a remote/hybrid position. The Utilization Review Physician Advisor (Advisor) conducts...SuggestedFull timeRemote workFlexible hours
- A leading healthcare provider in New York is seeking a Medical Doctor to oversee utilization review processes. The role requires collaboration with medical staff, critical decision-making on patient cases, and strong communication skills. Candidates must have a valid Medical...Suggested
- 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,...SuggestedRemote jobFor contractorsMonday to FridayFlexible hours
- About Dane Street Dane Street is a leading Independent Review Organization (IRO) and national provider of Utilization Review services. As we continue to expand our physician panel, we’re offering flexible, remote opportunities for board-certified physicians seeking supplemental...SuggestedExtra incomeFor contractorsRemote workFlexible hours
$230.85k - $282.15k
A leading health insurance company in Hingham is seeking a Physician Reviewer responsible for evaluating pre and post-service clinical service requests. The ideal candidate will utilize clinical judgment to assess appropriateness in coverage decisions, working closely...Full timeFlexible hours$172.9k - $230.5k
...nonprofit healthcare organization in New York is seeking an experienced medical professional to oversee utilization management for members. The role includes reviewing clinical information, ensuring compliance with guidelines, and contributing to quality care...- A healthcare technology company is seeking a Clinical Care Manager to advance patient-centered care through precise Utilization Review. This role demands clinical expertise to evaluate healthcare services while ensuring compliance and effective care coordination. Candidates...Remote job
- A healthcare company is seeking a Clinical Care Manager to advance high-quality, patient-centered care through Utilization Review. The ideal candidate will have an active RN license in Illinois and 5+ years of diverse healthcare experience. Responsibilities include evaluating...Remote job
- ...The support specialist is a support role crucial to the centralized Utilization Review team for time sensitive authorization tracking and resolution process. Responsible for obtaining and tracking approvals, denials, and additional information requests received from third...Shift work
Henry Ford Health System
Wyandotte, MI1 day ago - Rheumatology (MD/DO) Utilization Review - Remote Contract (1099) Apply for this independent contractor position with Medical Review Institute... .... The Opportunity We are seeking board‑certified physicians in rheumatology to conduct independent utilization reviews....Remote jobContract workFor contractorsFlexible hours
- ...Board-Certified Orthopedic Spine Surgeons for a fully remote, non-clinical role in Utilization Review. This opportunity offers flexibility and supplemental income, allowing physicians to provide evidence-based opinions on treatment requests without direct patient interaction...Remote jobExtra income
- ...insurance provider in Boston is seeking a Senior Manager for Clinical Review. This role involves leading the clinical review team, ensuring... ..., leadership experience, and a minimum of 5-7 years in utilization management within a health plan environment. A robust benefits...
- A leading healthcare provider is searching for a Medical Director to support the Medical Management staff with utilization reviews, appeals, and pharmacy oversight. This role requires an MD or DO with at least 3-5 years of clinical experience and a current medical license...Remote jobFull timeWork from home
$33 - $38 per hour
A healthcare solutions company is hiring Remote Clinical Review Nurses in Houston. The role involves reviewing cases for medical necessity... ...team. Candidates should have 3+ years of experience in utilization management and possess an Active RN Compact License. This is a...Remote job- A healthcare administration company seeks a Utilization Management Nurse to perform medical necessity reviews while working remotely. The ideal candidate will be an active Licensed Practical Nurse (LPN) with strong proficiency in the Utilization Review process. Responsibilities...Remote job
- ...A minimum of two (2) years experience in a clinical medical/healthcare setting is required. Previous experience in utilization review is strongly preferred. Qualified candidates must have strong computer skills (Excel) and must have knowledge of reporting...Full timeLocal area
Freedom Behavioral
Magnolia, MS2 days ago - ...elevate outcomes, and love your Mondays as the Nurse Director Utilization Review and Case Management at an award winning hospital in the Bay... ..., and readmission reduction—uniting social work, nursing, physicians, and ancillary teams to elevate every transition of care at...Remote workWeekend work
Clinical Management Consultants
Berkeley, CA3 days ago - ...JOB SUMMARY: Manages the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center. Ensures... ...requirements. Provides direction to staff regarding utilization review, care coordination, discharge planning, and other services...Local area
Macpower Digital Assets Edge
San Diego, CA5 days ago - ...Summary of Essential Duties: The Utilization Management (UM) Registered Nurse -... ...Denials supports post-discharge clinical reviews for Medicare Short Stay cases and assists... ...timelines. The UM RN collaborates with physicians, revenue integrity, and payer partners...
Cedars-Sinai
Los Angeles, CA13 days ago
