Average salary: $234,742 /yearly
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- ...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 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$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, MN1 day 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 $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
Indianapolis, IN4 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...SuggestedRemote work
Humana
Columbus, OH1 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, MI1 day 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, KS4 days 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...SuggestedRemote work
Humana
Saint Paul, MN4 days 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, AL4 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...SuggestedRemote work
Humana
Washington DC1 day 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...SuggestedRemote work
TurningPoint Healthcare Solutions
Florida, NY1 day 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...SuggestedLocal area
Hurc LLC
Short Hills, NJ2 days ago - Join Optum/UnitedHealth Group to support behavioral health and substance abuse case management through utilization reviews and care coordination. While not a member facing role, you'll help ensure they receive the right level of care at the right time. This is a fully remote...SuggestedRemote workMonday to Friday
Optum
Phoenix, AZ3 days 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...SuggestedLocal area
Macpower Digital Assets Edge
San Diego, CA19 hours 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, CA3 days ago $1,100 per week
...Job Description VHS is looking for a qualified Registered Nurse - Case Manager/Utilization Review. City: Syracuse State: NY Start Date: TBD End Date: TBD Duration: 13 Weeks Shift: 8 Hours Days. Skills: Nursing W2 Pay Rate...Weekly payDaily paidLocal areaShift workVieMed Healthcare Staffing
Solvay, NY4 days ago- ...A leading healthcare provider is looking for an experienced Registered Nurse in Peoria, Illinois. The role focuses on utilization review, clinical consultation, and effective patient support within a fully remote setting. Candidates should have an active Illinois RN license...Remote workWork from home
Guidehealth
Peoria, IL1 day ago $70.97 - $125 per hour
...sector. Job Description Acentra seeks a Psychiatrist Physician Reviewer (PRN) to join our growing team. Job Summary: The Psychiatrist... ...to operations relating to the peer review process, utilization review activities, and other activities requiring clinical...Hourly payReliefLocal areaRemote workCNSI
United States19 hours ago- ...maintaining client-mandated turnaround times. Our reviewers are compensated on a per-case basis as a... ...may be needed JOB SUMMARY Utilizes clinical expertise and reviews insurance... ...and retrospective claims. The Physician Reviewer will provide an interpretation...For contractors
Dane Street
Bellevue, WA19 hours ago $57.28 - $88.92 per hour
...A healthcare organization in California is seeking a Utilization Management RN to conduct clinical reviews and manage utilization reviews for their Southern CA ministries. The ideal candidate must have a strong clinical background, California RN License, and experience...Hourly payRemote workProvidence Health & Service
Mission Hills, CA4 days ago$2,479 per week
Travel Nurses, Inc. is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Orange, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 05/04/2026 Duration: 13 weeks 40 hours per week Shift...Weekly payShift workTravel Nurses, Inc.
Villa Park, CA3 hours agonew$1,508 per week
GQR Healthcare is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Webster, Texas. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 05/04/2026 Duration: 13 weeks 40 hours per week Shift: 8 hours...Hourly payWeekly payShift workGQR Healthcare
Fondren, TX3 hours agonew- ...A healthcare organization is looking for a Utilization Management RN in Mission Hills, California, to provide prospective, retrospective, and concurrent reviews for ministries. Candidates should have strong clinical skills, a nursing degree, and California RN license....Remote work
Providence Service
Mission Hills, CA4 days ago $2,477 per week
...Travel Nurses, Inc. is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Everett, Washington. Job Description & Requirements ~ Specialty: Utilization Review ~ Discipline: RN ~ Start Date: 05/04/2026 ~ Duration:...Weekly payShift workTravel Nurses Inc
Everett, WA1 day ago$40 - $45 per hour
...TX. This fully remote contract position requires 4+ years of RN experience in utilization management and a Compact RN license. Responsibilities include performing concurrent health reviews, evaluating care delivery for necessity, and assisting in discharge planning. Competitive...Contract workRemote workActalent
Austin, TX4 days ago- ...Job Description Job Description Vivo HealthStaff is recruiting for a Utilization Review Physician based in New York for a Managed Care Insurance Plan. This position requires 4 days per month on-site. The Utilization Review Physician is the lead clinician for...Remote job
- ...Description Job Description: Manager of Clinical Utilization Management - Denial Compliance... ...staff, managing daily tasks, performance reviews, and any necessary disciplinary actions.... ...communication and collaboration with physician reviewers, medical directors, and other...Permanent employmentFull timeTemporary workRemote workFlexible hours
$223.8k - $313.1k
...A healthcare services company is seeking a Medical Director to provide expert clinical review of inpatient medical records and determine medical necessity. This role requires collaboration with a supportive medical team, focusing on case analysis without the physical...Remote workHumana
Richmond, VA4 days ago- ...A healthcare organization is seeking a Medical Director to perform clinical reviews of inpatient medical records, ensuring compliance with medical necessity guidelines. The ideal candidate will have an MD or DO, along with 5+ years of clinical experience in a hospital...Remote work
Humana
Carson City, NV4 days ago
