Average salary: $234,742 /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, CA3 days 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
- ...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
Medical Review Institute
Salt Lake City, UT1 day 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
Rockford, IL1 day ago - ...A leading healthcare organization is seeking a dedicated Physician Advisor to join their Utilization Review team. This full-time role involves conducting medical necessity reviews, managing denials, and collaborating with healthcare staff to ensure documentation compliance...SuggestedFull timeRemote work
Inova Health System
Fairfax, VA1 day 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
$248.5k - $373k
...deliver clinical coverage and medical claims reviews. Our role is to empower providers and... ...costs. The Medical Director provides physician support to Enterprise Clinical Services... ...application of clinical knowledge in various utilization management activities with a focus on...SuggestedRemote jobMinimum wageWork experience placementLocal area- 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
$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-based...SuggestedHourly payFull timeLocal areaFlexible hoursWeekend workHispanic Alliance for Career Enhancement
Chicago, IL4 days 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, MN1 day 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 States1 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, NY18 minutes agonew - 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
- ...Management/Health Services team. The ideal candidate must hold an RN or LPN/LVN compact license and have experience in clinical reviews and utilization management. Responsibilities include drafting clinical correspondence, investigating denials, and collaborating with...SuggestedRemote workFlexible hours
Centene Corporation
Columbia, SC2 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...Minimum wageFull timeLocal areaRelocationRelocation packageShift workDay shift1 day per week- ...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...Remote workFlexible hours
Medical Review Institute
Dallas, TX1 day 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, MI1 day 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
Columbia, SC4 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, 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
Rancho Cordova, CA34 minutes agonew - ...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, OH1 day 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,...Remote jobFor contractorsMonday to FridayFlexible 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...$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- ...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 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 DC1 day 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, CA1 day ago - ...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, TN1 day 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, TX4 days ago
