Average salary: $226,319 /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, CA15 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
$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- ...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 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
- .... 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
- ...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 - ...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, NY2 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
- ...documentation, data capture and opportunities for utilization are compliant, accurate and consistent.... ..., follow-up and focused chart audits/reviews (concurrent and retrospective) for the... ...) - State of Florida (FL) Osteopathic Physician License (OS LICENSE) - State of Florida...SuggestedWork experience placementWeekend work
- 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
- A leading healthcare provider in New York is seeking a Medical Doctor to oversee utilization review processes. The role requires collaboration with medical staff, critical decision-making on patient cases, and strong communication skills. Candidates must have a valid Medical...Suggested
- 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 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,...SuggestedRemote jobFor contractorsMonday to FridayFlexible hours
- ...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...SuggestedExtra incomeContract workFor contractorsRemote workFlexible 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...$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
- 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 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
- 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
$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 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
$33 - $38 per hour
A healthcare solutions company is hiring Remote Clinical Review Nurses in Houston. The role involves reviewing cases for medical necessity... ...team. Candidates should have 3+ years of experience in utilization management and possess an Active RN Compact License. This is a...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
$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, CA11 hours agonew- ...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 - ...Job Description Job Summary: Key Job Responsibilities The Post-Procedure Utilization Management (UM) Registered Nurse is responsible for performing real-time utilization review for surgical and procedural patients immediately following procedures. This role ensures...Immediate startNight shift
Cedars-Sinai
Los Angeles, CA15 hours ago - ...JOB SUMMARY: Manages the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center. Ensures... ...requirements. Provides direction to staff regarding utilization review, care coordination, discharge planning, and other services...Local area
Macpower Digital Assets Edge
San Diego, 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, CA15 hours ago
