Average salary: $234,742 /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
- A leading Independent Review Organization is looking for Board-Certified Psychiatrists for a fully remote role. This position involves conducting utilization reviews and provides flexible scheduling along with supplemental income. Responsibilities include reviewing medical...SuggestedRemote jobExtra incomeFlexible hours
$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- ...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
- 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
$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, NY3 days ago$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, NY2 days 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 $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 week- 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
- ...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...SuggestedLocal area
Hurc LLC
Short Hills, NJ2 days ago $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-...SuggestedHourly payFull timeLocal areaFlexible hoursWeekend work- 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...SuggestedExtra incomeFor contractorsRemote workFlexible hours
- ...The Medical Director of Case Management and Utilization Review leads the hospital specific execution of the Case Management (CM) and Utilization... ...activities. The Medical Director functions as the primary physician advisor for the hospital and supervises other Physician...SuggestedWork experience placement
- 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
- 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
$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...$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- 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
- 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 jobFlexible hours
- ...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 job
- ...Summary of Essential Duties: The Utilization Management (UM) Registered Nurse –... ...Denials supports post-discharge clinical reviews for Medicare Short Stay cases and assists... ...timelines. The UM RN collaborates with physicians, revenue integrity, and payer partners...
Cedars-Sinai
Los Angeles, CA2 days 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 - A leading Independent Review Organization is looking for Board-Certified Orthopedic Spine... ...for a fully remote role performing utilization reviews. Candidates must have an active... ...offers flexibility in scheduling and allows physicians to earn supplemental income without patient...Remote jobExtra income
- 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
$29.05 - $67.97 per hour
..., is seeking a clinical professional to support medical claim reviews and internal appeals. This role ensures compliance with federal... ...should be Registered Nurses with relevant experience in utilization review and medical claims, excellent analytical and organizational...Hourly pay$30.5 - $59.47 per hour
...support medical claims and internal appeals. Responsibilities include facilitating clinical reviews, verifying medical records, and resolving complaints regarding utilization management. Ideal candidates will have at least 2 years of clinical experience, strong communication...Hourly payFull time- A healthcare organization in the SF Bay Area is seeking an experienced Interim UM Assistant Nurse Manager to lead utilization review. This full-time role requires a steady, clinically strong leader who will stabilize and support staff while the hospital conducts a permanent...Permanent employmentFull timeInterim role
