Average salary: $232,650 /yearly
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$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, CA14 hours 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
$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 shiftPhysician / Surgery - Plastic / Vermont / Permanent / Plastic Surgeon - Utilization Review Physician
...Dane Street , a nationally recognized Independent Review Organization (IRO) and leading provider of Utilization Review (UR) services, is expanding its panel of physician reviewers. Read on to fully understand what this job requires in terms of skills and experience If...SuggestedPermanent employmentRemote workWork from homeFlexible hoursDane Street
Los Angeles, CA2 days ago- 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
- ...A healthcare organization is looking for a Board-Certified Family Medicine physician to assist in remote utilization review work. This flexible role requires evaluating medical records and ensuring compliance with clinical guidelines. Candidates must have a medical license...SuggestedFor contractorsRemote workFlexible hours
Medical Review Institute
Orlando, FL1 day ago $29.62 - $45.31 per hour
...that to inspire and retain the best people, we must empower them. Role Overview Providence Health Plan is calling an Associate Utilization Review Specialist who will: Be responsible for all core functions in the Prior Authorization (PA) Department Coordinate and...SuggestedRemote jobMinimum wageFull timeWork experience placementLocal areaShift work- ...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
$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 weekProvidence Health and Services
Chugiak, AK2 days 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...SuggestedRemote jobExtra incomeFlexible hours
- ...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 States3 days 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
- 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
$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
Hartford, CT1 day ago- ...their collaborative team. The role involves conducting clinical reviews of inpatient medical records to ensure appropriate care.... ...position provides the opportunity to work within a structured team, utilizing strong analytical skills to make informed decisions. Benefits include...SuggestedRemote work
Humana
Montgomery, AL1 day ago - ...A healthcare company is looking for a Medical Director to review inpatient medical records and determine medical necessity based on... ...five years of clinical experience and a solid understanding of utilization management. Strong communication skills and the ability to...Remote work
Humana
Saint Paul, MN1 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 DC3 days ago - ...organization is seeking a Medical Director to provide expert clinical reviews of inpatient medical records and determine medical necessity... ...have extensive clinical experience and a background in utilization management or hospital settings. Join this dedicated team to impact...Remote work
Humana
Topeka, KS1 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...Extra incomeContract workFor contractorsRemote workFlexible hours
- 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,...Remote jobFor contractorsMonday to FridayFlexible hours
- 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
- 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
- ...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, NJ4 days ago $25 - $37.47 per hour
...Utilization Review Specialist Pacific Grove Hospital in Riverside, CA., is a leader in behavioral healthcare, providing superior healthcare treatment to the people, communities, and military installations we serve. We are a private inpatient 68 bed acute psychiatric...Hourly payReliefWork at officeAcadia Healthcare
Riverside, CA14 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- ...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, MI4 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 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
- 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
- ...Utilization Review Consultant Utilization Review Consultant oversees utilization management for ICE Health Service Corps, ensuring appropriate healthcare for detainees. Duties include evaluating off-site services, mentoring staff, maintaining records, liaising with...
