Average salary: $232,650 /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
Physician / 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, CA1 day ago- ...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, FL4 hours agonew - A leading medical review organization is seeking a Board-Certified Sports Medicine/Family Medicine physician for a remote Independent Contractor role. The physician will perform utilization review work, ensuring healthcare services are necessary and compliant. Responsibilities...SuggestedRemote jobFor contractors
- ...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- .... ABOUT MRIoA Founded in 1983, Medical Review Institute of America (MRIoA) is a nationally... ...(IRO) specializing in technology‑driven utilization management and clinical medical review... ...Sports Medicine/Family Medicine physician to assist in Utilization Review work, which...SuggestedFor contractorsRemote workWork from homeFlexible hours
$29.62 - $45.31 per hour
Description 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 execute the review and research functions required to support the PA Department...SuggestedRemote jobWork experience placementLocal area- ...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 States2 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...SuggestedMinimum wageFull timeLocal areaRelocationRelocation packageShift workDay shift1 day per weekProvidence Health and Services
Chugiak, AK1 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...SuggestedRemote jobExtra incomeFlexible hours
- 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
$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
Richmond, VA1 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...SuggestedFull timeRemote workIntegra Partners
Troy, MI2 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, KS4 hours agonew $230.85k - $282.15k
A leading health insurance company in Hingham is seeking a Physician Reviewer responsible for evaluating pre and post-service clinical service requests. The ideal candidate will utilize clinical judgment to assess appropriateness in coverage decisions, working closely...Full timeFlexible hours- 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 job
- ...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...Remote work
Humana
Montgomery, AL4 hours agonew - ...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, MN4 hours agonew - 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 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...- ...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, NJ3 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, NV2 days 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- 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
$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, CA4 days ago- 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
- ...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, MI3 days ago
