Average salary: $238,735 /yearly
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$103 per hour
...Senior Utilization Review Specialist The Senior Utilization Review Specialist collaborates with the healthcare team in the management and... ...documentation requirements ~ Education/Advisory ~ a. Physician Educator ~ b. Provide formal educational lectures and engage...SuggestedHourly payDaily paidFull timeContract workPart timeFor contractorsApprenticeshipWork experience placementShift workNight shiftWeekend workAfternoon shift- ...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...SuggestedExtra incomeRemote workFlexible hours
Dane Street
New York, NY4 days ago - ...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
Peoria, 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 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...SuggestedFor contractorsRemote workMonday to FridayFlexible hours
Dane Street
Washington DC4 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 role...SuggestedPrice workExtra incomeFor contractorsRemote workFlexible hours
Dane Street
New York, NY22 hours ago $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- ...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, NY3 days ago - ...A healthcare management firm is seeking a Physician Reviewer to join their remote team. The role involves performing real-time case reviews... ...The position offers flexibility and requires knowledge in utilization management and experience with Medicare and Medicaid. #J-18...SuggestedRemote work
Tango
Phoenix, AZ4 days ago - ...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
Dane Street
Wausau, WI4 days ago - ...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 - ...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...SuggestedRemote work
Humana
Columbus, OH4 days ago $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...SuggestedFull timeTemporary workApprenticeshipRemote workMonday to FridayFlexible hoursShift workWeekend workHumana
Columbia, SC3 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...SuggestedRemote workHumana
Jefferson City, MO4 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...SuggestedRemote workFlexible hours
VALID8 Financial
Austin, TX2 days ago $234.63k - $336.6k
...care system in California. The Medical Director, Utilization Management will report to the Sr. Medical Director... ...you will deliver and collaborate on clinical review activities, which includes management of the physician processes in support of utilization management and...Full timeWork at officeBlue Shield Of California
Woodland Hills, CA3 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- ...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 recognized Independent Review Organization is seeking Board-Certified Orthopedic Spine Surgeons for a remote Physician Reviewer role. This non-clinical position focuses on conducting utilization reviews without direct patient interaction. Responsibilities include reviewing...Extra incomeRemote workFlexible hours
Dane Street
New York, NY4 days ago - ...A leading pharmacy benefits manager is seeking a Physician Clinical Reviewer specialized in Dermatology for a remote role. This position involves... .... This is an opportunity to contribute to effective utilization management processes while working within a supportive team...Remote work
Prime Therapeutics
Tallahassee, FL4 days ago - ...A healthcare organization is seeking a Physician Clinical Reviewer specializing in Dermatology to join their utilization management team. This remote role involves reviewing medical service requests, collaborating with healthcare professionals, and ensuring compliance...Remote work
Prime Therapeutics
Baton Rouge, LA4 days ago - ...A healthcare organization is seeking a Physician Clinical Reviewer for a remote opportunity. In this role, you will be a key member of the utilization management team, performing medical reviews of service requests and collaborating with physicians to ensure compliance...Remote work
Prime Therapeutics
Carson City, NV4 days ago $223.8k - $313.1k
...company is seeking a Medical Director to provide expert clinical reviews and advance patient outcomes. This remote position emphasizes... ...abilities. Join a dedicated team focused on effective utilization management while enjoying a competitive compensation range of...Remote workHumana
Springfield, IL4 days ago- ...A leading pharmacy benefit management company is seeking a Physician Clinical Reviewer for a remote position. You will play a crucial role in the utilization management team by providing timely medical reviews of service requests, interacting routinely with physicians...Remote work
Prime Therapeutics
Montgomery, AL4 days ago - ...A healthcare management company in Concord, NH, seeks a Clinical Reviewer, Nurse to join their utilization management team. This role involves evaluating authorization cases, analyzing clinical records, and ensuring quality of care. Required qualifications include a current...Flexible hours
Evolent
Concord, NH4 days ago $223.8k - $313.1k
A leading healthcare company in Madison, Wisconsin, seeks a Medical Director to oversee care management and utilization review. This position requires an MD or DO degree, along with over 5 years of clinical experience. The role involves coordinating with healthcare teams...Remote job- ...leader in providing behavioral health services to the underserved community, is currently seeking a driven Clinical Supervisor – Utilization Review to join our mission to provide compassionate services to those with limited resources. Our ideal candidate will have a...Local areaImmediate startShift work
Kings View Corporation
Fresno, CA6 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, CA1 day 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, CA3 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, CA1 day ago
