Average salary: $234,742 /yearly
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$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...SuggestedMinimum wageWork experience placementLocal areaRemote workCouncil Of State and Territorial Epidemiologists
Kahului, HI3 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
Medical Review Institute
Salt Lake City, UT3 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
- ...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, IL3 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...SuggestedExtra incomeRemote workFlexible hours
Dane Street
New York, NY3 days 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, VA3 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
Dane Street
Delaware, OH3 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
$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$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, IL1 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 role...SuggestedPrice workExtra incomeFor contractorsRemote workFlexible hours
Dane Street
New York, NY4 days ago - The Per Diem Advanced Practice Nurse (APN) for Utilzation Review utilizes a patient-centered coordinated care model, demonstrating competencies... ...to New Jersey state law. Collaborative agreement with physicians on staff. Excellent written and verbal communication skills...SuggestedDaily paidWork at office
$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, NY4 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, MN3 days 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, NY19 hours 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...Full timeLocal areaRemote workWeekend work
Medix
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...For contractorsRemote workMonday to FridayFlexible hours
Dane Street
Washington DC3 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...Remote work
Tango
Phoenix, AZ3 days ago - ...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...Remote workFlexible hours
Centene Corporation
Columbia, SC4 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- ...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
Dane Street
Wausau, WI3 days 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...Full timeRemote 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, TX1 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, CA1 day 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...Remote workFlexible hours
Medical Review Institute
Dallas, TX3 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
Albany, NY1 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...Remote work
Humana
Columbus, OH3 days 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, TN3 days 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, MI3 days ago- ...A growing healthcare company is seeking an entry-level Utilization Review Nurse for a fully remote position. Responsibilities include performing clinical reviews, assisting in quality improvement projects, and interacting with healthcare providers. Candidates must have...Remote work
TurningPoint Healthcare Solutions
Florida, NY3 days ago
