Average salary: $238,735 /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
- Part-Time | Remote (U.S. Based) Medical Review Institute of America (MRIoA) is a nationally recognized leader in utilization management and clinical review services, delivering... ...evidence-based solutions for more than Physician Advisor (Utilization Review) Part-Time |...SuggestedPart timeWork at officeRemote workWork from home10 hours per weekFlexible hoursShift workWeekend work
- ...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, IL1 day ago - ...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, NY1 day ago - ...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
Dane Street
Delaware, OH14 hours 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
- ...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, NY2 days ago - ...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 DC1 day 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, WI1 day 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, AZ1 day 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, NY6 hours 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 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, TX1 day 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, OH1 day 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, MO1 day ago- ...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 office
Blue Shield of CA
Lodi, CA5 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...Full timeTemporary workApprenticeshipRemote workMonday to FridayFlexible hoursShift workWeekend workHumana
Augusta, ME6 hours ago$211.2k - $277.2k
New York, New York, United States 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...Local areaRemote workWork from homeHome officeWeekend work$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-...Hourly payFull timeLocal areaFlexible hoursWeekend work$71.03k
Arizona State Government is hiring a Behavioral Health Prior Authorization Utilization Review Consultant to monitor and evaluate healthcare services within Arizona's Medicaid agency. Responsibilities include collaborating with healthcare providers and conducting utilization...Remote 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...Remote job
- 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...Remote job
$275k - $300k
...00,000) ~ 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 ~ ASAP start date ~ Sacramento is the state's capital and has...Full timeImmediate startRemote workWork from homeMonday to FridayInspire Healthcare
United States4 days ago- 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...Extra incomeFor contractorsRemote workFlexible hours
- ...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, TX4 days ago - 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 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, NH1 day 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, NV1 day 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 - ..., visit or Job Title: Nurse Case Manager - Utilization Review Requisition Number: 44170 Employment Type: Full... ...coordinating the care and service of assigned patients with physicians, nurses, social workers and other members of the healthcare...Hourly payFull timeShift workDay shift
JPS Health Network
Fort Worth, TX4 days ago
