Average salary: $234,742 /yearly
More statsGet new jobs by email
- 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
$103 per hour
...Senior Utilization Review Specialist The Senior Utilization Review Specialist collaborates with the healthcare team in the management and... ...and documentation requirements Education/Advisory a. Physician Educator b. Provide formal educational lectures and engage in...SuggestedHourly payDaily paidFull timeContract workPart timeFor contractorsApprenticeshipWork experience placementShift workNight shiftWeekend workAfternoon shift- ...to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality... ...the exam room for all patients. What You’ll Be Doing Utilization Review & Clinical Determinations Complete timely review of healthcare...SuggestedBi-weekly payFull timeTemporary workFor contractorsLocal areaRemote workWork from home
Guidehealth
Rockford, IL4 days ago - ...with standards. The ideal candidate is a board-certified MD or DO with at least 6 years of clinical experience and 1 year in utilization review. Responsibilities include timely medical reviews, clinical determinations, and accurate documentation. Licensure in Florida or...SuggestedFull time
- A national independent review organization is looking for Board-Certified Physical Medicine and Rehabilitation providers for a fully... ...remote, non-clinical role. This position involves conducting Utilization Reviews, where providers will review medical records to determine...SuggestedRemote jobExtra incomeContract workFlexible hours
- 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
$90.87 - $154.33 per hour
...A healthcare organization seeks a Physician Clinical Reviewer in Gastroenterology to provide medical review for service requests remotely. Candidates... ...to impact patient care and work collaboratively in a utilization management team while enjoying a competitive salary...SuggestedRemote workPrime Therapeutics
Saint Paul, MN4 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 States4 days ago - 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 healthcare review organization seeks a Physician Reviewer/Advisor in Delaware, Ohio. This role involves utilizing clinical expertise to review insurance appeals and claims while ensuring compliance with established guidelines. Responsibilities include thorough medical...SuggestedExtra income
- ...A healthcare organization is seeking Board-Certified physicians in Oncology for a flexible, remote utilization review role. This position requires a Medical Degree (MD or DO) with a current license in Florida, Minnesota, or Oregon, and an active Board Certification in...SuggestedRemote workFlexible hours
Medical Review Institute
Dallas, TX4 days ago $43.29 - $76.06 per hour
...assessment and planning, coordination of care, resource utilization management and/ or review, discharge planning, documentation of interventions,... ...diagnostics and treatment, outpatient health centers, physician groups and clinics, outreach programs, and hospice and...SuggestedMinimum wageFull timeLocal areaRelocationRelocation packageShift workDay shift1 day per week- ...among the first 25 applicants Description Dane Street, a leading Independent Review Organization (IRO) and national provider of Utilization Review (UR) services, is currently expanding our physician panel. We are seeking Board-Certified Orthopedic Surgeons with an active...SuggestedExtra incomeContract workFor contractorsRemote workFlexible 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...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
$223.8k - $313.1k
...Director relies on medical background and reviews health claims. The Medical Director... ...factors. Join a collaborative team of physicians who bring clinical expertise to medical... ...Physicians, and Physicians with Inpatient or Utilization Review Experience Role Overview Provide...Full timeTemporary workApprenticeshipRemote workMonday to FridayFlexible hoursShift workWeekend workHumana
Augusta, ME2 days ago$250k
...A national healthcare solutions provider is seeking a Utilization Review Medical Director to conduct clinical reviews of Durable Medical Equipment requests. This full-time role emphasizes adherence to workflow timelines and requires an MD or DO degree along with board...Full timeRemote workIntegra Partners
Troy, MI4 days ago$223.8k - $313.1k
...organization is seeking a Medical Director in Jefferson City, Missouri. The role involves conducting clinical reviews of inpatient records and making utilization management determinations. Candidates should possess an MD or DO, an active medical license, and at least 5...Remote workHumana
Jefferson City, MO4 days ago- ...is seeking an experienced Medical Director to conduct clinical reviews and guide decision-making in inpatient care. The role... ...of clinical experience, with a focus on hospital medicine and utilization review. Join a distinguished team to impact patient outcomes while...Remote work
Humana
Columbus, OH4 days ago - ...Utilization Review Medical Director - Remote Medical Review Institute of America (MRIoA) is a market leader in utilization management and... ...solutions. We are seeking a full‑time, remote Medical Director (Physician Reviewer) to evaluate clinical service requests and...Full timePart timeRemote workShift workWeekend work
Medical Review Institute
Los Angeles, CA4 days ago $211.2k - $277.2k
...Physician Reviewer - Utilization Management You will determine the medical appropriateness of inpatient, outpatient, and pharmacy services by reviewing clinical information and applying evidence-based guidelines. Hours: 8am - 5pm in your local time zone. Call rotation...Full timeLocal areaRemote workWork from homeHome officeWeekend work- ...Director to conduct inpatient medical necessity reviews while collaborating with healthcare providers. This role requires a physician with at least 5 years of post-residency... ...performing clinical reviews, providing utilization management determinations, and ensuring compliance...Remote workMonday to Friday
Humana, Inc.
Nashville, TN4 days ago - ...A health insurance startup is looking for an experienced Medical Director to oversee utilization reviews and prior authorizations. This remote position demands a strong clinical background with a doctorate in medicine and board certification. The ideal candidate will have...Remote workFlexible hours
VALID8 Financial
Austin, TX1 day ago - ...A leading healthcare company in Washington, D.C. is seeking a Medical Director to oversee inpatient medical necessity reviews and utilization management. This role requires strong analytical and communication skills, as well as 5+ years of clinical experience post-residency...Remote work
Humana
Washington DC4 days ago - 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
- ...A growing healthcare company is seeking an entry-level Utilization Review Nurse for a fully remote position. Responsibilities include performing clinical reviews, assisting in quality improvement projects, and interacting with healthcare providers. Candidates must have...Remote work
TurningPoint Healthcare Solutions
Florida, NY4 days ago - ...The Utilization Review (UR) Clinical Lead is responsible for overseeing and guiding the utilization review process to ensure medical necessity, regulatory compliance, and appropriate use of healthcare resources. This role provides clinical leadership to the UR team, supports...Local area
Hurc LLC
Short Hills, NJ13 hours ago $50 per hour
A healthcare provider in California is seeking a full-time Assistant DON/Utilization Review Nurse. The role involves ensuring adherence to the hospital’s utilization review plan and overseeing nursing standards. Candidates must possess a State of Nevada Nursing License...Full time$54 - $66 per hour
...A prominent healthcare staffing agency is seeking a Utilization Review Nurse in Sacramento, CA, responsible for managing the daily operations of the UM Pre-Authorization team. The ideal candidate will ensure accurate processing of referral requests, maintain regulatory...Pacific Staffing
Sacramento, CA4 days 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
