Average salary: $234,742 /yearly
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- 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
- A leading Independent Review Organization is looking for Board-Certified Psychiatrists for a fully remote role. This position involves conducting utilization reviews and provides flexible scheduling along with supplemental income. Responsibilities include reviewing medical...SuggestedRemote jobExtra incomeFlexible hours
$264k - $277k
...leading health insurance provider is seeking a fully remote Physician Reviewer to assess care requests for compliance with medical... ...requires board certification as an MD or DO, and 1+ years of utilization review experience. Candidates should have 5-6+ years of clinical...SuggestedRemote jobFlexible hours- ...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
$172.9k - $230.5k
...Overview Oversees the utilization of medical care and treatment of VNS MSO members and provides direction and guidance to the staff to... ...Management (UM), initial and internal appeals decisions. This includes review of clinical information provided against evidence-based...SuggestedWork experience placementRemote workFlexible hoursVNS Health
New York, NY1 day ago$211.2k - $277.2k
...Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the...SuggestedFull timeLocal areaRemote workWork from homeHome officeWeekend workOscar Health
New York, NY2 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 States18 hours 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- 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
- ...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...SuggestedLocal area
Hurc LLC
Short Hills, NJ1 day ago - A health insurance company is seeking a Physician Reviewer to join their Utilization Management team. This remote role involves determining the medical appropriateness of services by reviewing clinical information and adhering to evidence-based guidelines. Candidates must...SuggestedRemote job
- 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...SuggestedRemote job
$174.07k - $374.92k
...bigger - helping to simplify health care one person, one family and one community at a time. Role Description The Utilization Management Physician Reviewer ensures timely and clinically sound coverage determinations for inpatient and outpatient services using evidence-...SuggestedHourly payFull timeLocal areaFlexible hoursWeekend work$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$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...SuggestedFull time- ...The Medical Director of Case Management and Utilization Review leads the hospital specific execution of the Case Management (CM) and Utilization... ...activities. The Medical Director functions as the primary physician advisor for the hospital and supervises other Physician...Work experience placement
- 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
- ...Job Description Job Summary: Key Job Responsibilities The Post-Procedure Utilization Management (UM) Registered Nurse is responsible for performing real-time utilization review for surgical and procedural patients immediately following procedures. This role...Immediate startNight shift
Cedars-Sinai
Los Angeles, CA2 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, CA2 days ago - A leading Independent Review Organization is looking for Board-Certified Orthopedic Spine... ...for a fully remote role performing utilization reviews. Candidates must have an active... ...offers flexibility in scheduling and allows physicians to earn supplemental income without patient...Remote jobExtra income
- 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
- ...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, CA2 days ago $30.5 - $59.47 per hour
...support medical claims and internal appeals. Responsibilities include facilitating clinical reviews, verifying medical records, and resolving complaints regarding utilization management. Ideal candidates will have at least 2 years of clinical experience, strong communication...Hourly payFull time- A healthcare organization in the SF Bay Area is seeking an experienced Interim UM Assistant Nurse Manager to lead utilization review. This full-time role requires a steady, clinically strong leader who will stabilize and support staff while the hospital conducts a permanent...Permanent employmentFull timeInterim role
$29.05 - $67.97 per hour
..., is seeking a clinical professional to support medical claim reviews and internal appeals. This role ensures compliance with federal... ...should be Registered Nurses with relevant experience in utilization review and medical claims, excellent analytical and organizational...Hourly pay$36.7 - $69.38 per hour
...currently seeking a Staff Nurse to join our Utilization Management department for the Emergency... ...RESPONSIBILITIES: The Utilization Review (UR) Registered Nurse is responsible for... ...services. Initiates communication with physicians and payers to resolve authorization...Temporary workShift workWeekend workAfternoon shiftHennepin County Medical Center
Minneapolis, MN18 hours ago- ...currently seeking a Staff Nurse to join our Utilization Management department for the/Emergency... ...RESPONSIBILITIES: The Utilization Review (UR) Registered Nurse is responsible for... ...services. Initiates communication with physicians and payers to resolve authorization...Shift workWeekend workAfternoon shift
Minnesota Visiting Nurse Agency
Minneapolis, MN4 days ago $685 - $700 per day
Interim Assistant Nurse Manager, Utilization Review/Discharge Planning Healthcare Executive Placements, Inc. (HCEPInc) is seeking an Interim... .... Oversee discharge planning activities, coordinating with physicians, nurses, social workers, and community resources to ensure...Daily paidFull timeContract workInterim roleMonday to Friday- A healthcare organization seeks Clinical Reviewer Unit Physicians to adjudicate coverage requests using professional standards. Responsibilities include conducting reviews, managing appeals, and consulting with external systems. Candidates must have a medical degree, 3...
