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, HI2 days 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
Peoria, IL2 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, NY2 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, VA2 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, OH2 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 role...SuggestedPrice workExtra incomeFor contractorsRemote workFlexible hours
Dane Street
New York, NY3 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...SuggestedFor contractorsRemote workMonday to FridayFlexible hours
Dane Street
Washington DC2 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, NY3 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, 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, MN2 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...SuggestedRemote work
Tango
Phoenix, AZ2 days ago - ...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
Dane Street
Wausau, WI2 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...SuggestedRemote workFlexible hours
Centene Corporation
Columbia, SC3 days 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...SuggestedFull timeWork at office
Blue Shield of CA
Redding, CA1 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...SuggestedFull timeTemporary workApprenticeshipRemote workMonday to FridayFlexible hoursShift workWeekend workHumana
Albany, NY1 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, TX20 hours 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...Full timeRemote workWork from home
Hispanic Alliance for Career Enhancement
Chicago, IL2 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$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, MI2 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, TN2 days 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, OH2 days ago - ...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 DC2 days 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, CA2 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, MO2 days 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, TX2 days ago - ...A healthcare organization is looking for a Physical Therapy Utilization Management Reviewer in Hingham to evaluate outpatient rehabilitation services. The role involves conducting various reviews, collaborating with a dedicated team of healthcare professionals, and ensuring...
Blue Cross Blue Shield of Massachusetts
Hingham, MA2 days ago $16.36 - $26.31 per hour
...A national risk management provider is seeking a UR Intake Specialist to support its Utilization Review department. This hybrid position involves handling precertification requests, maintaining accurate records, and requires excellent communication skills. Candidates...Hourly payFull timeCorVel
Downers Grove, IL2 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, NY2 days ago - ...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 - ...Utilization Review Specialist Location: Highland Springs in Highland Hills, OH Schedule: Full Time, Day Shift Your experience matters... ..., external reviews, and other payers Communicate with physicians to schedule peer to peer reviews Accurately report denials...Full timeTemporary workPart timeFlexible hoursDay shift
LifePoint Health
Beachwood, OH20 hours ago
