Average salary: $232,650 /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, CA8 hours ago- A leading healthcare provider is searching for a Utilization Management Physician Reviewer. This remote part-time role demands clinical expertise to review prior authorizations and engage with healthcare professionals while ensuring compliance with regulations. Candidates...SuggestedPart timeRemote workFlexible hours
$103 per hour
...Senior Utilization Review Specialist The Senior Utilization Review Specialist collaborates with the healthcare team in the management and... ...and documentation requirements Education/Advisory a. Physician Educator b. Provide formal educational lectures and engage in...SuggestedHourly payDaily paidFull timeContract workPart timeFor contractorsApprenticeshipWork experience placementShift workNight shiftWeekend workAfternoon shiftPhysician / 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, CA2 days 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, FL1 day ago 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. We are currently seeking Board-Certified Plastic Surgeons with an active Louisiana medical...SuggestedPermanent employmentRemote workFlexible 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$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, AK2 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
- ...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 - The Utilization Review Physician 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 University Medical Center. These include but are not limited to...SuggestedPermanent employment
$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
Augusta, ME1 day ago- ...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...SuggestedRemote work
Humana
Montgomery, AL1 day 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...SuggestedRemote work
Humana
Washington DC3 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...SuggestedRemote work
Humana
Topeka, KS1 day ago - ...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, MN1 day ago - 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
- 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
- Job Summary and Responsibilities As the Utilization Management (UM) Physician Reviewer, you will report to the Medical Director of UM and provide clinical expertise to ensure high‑quality, medically necessary, and efficient patient care aligned with regulatory requirements...Part timeLocal areaRemote workFlexible hours
- 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
- ...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, NJ4 days ago $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, CA8 hours ago- ...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, MI4 days ago - 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
- ...Utilization Review Consultant Utilization Review Consultant oversees utilization management for ICE Health Service Corps, ensuring appropriate healthcare for detainees. Duties include evaluating off-site services, mentoring staff, maintaining records, liaising with...
$250k
...Utilization Review Medical Director The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical... ..., and regulatory requirements. This role is best suited for physicians who thrive in a process-driven environment and are committed...Full timeTemporary workRemote work- A healthcare services provider is seeking an Associate Utilization Review Specialist to oversee prior authorization processes. This remote position requires a Bachelor's degree or equivalent experience in healthcare, and a strong background in critical thinking and database...Remote job
- ...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, CA8 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 - ...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, CA8 hours ago
