Average salary: $251,721 /yearly
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- ...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...SuggestedPermanent employmentFull timeTemporary workRemote workFlexible hours
Vivo HealthStaff
Burbank, CAa month ago - ...A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or DPM degree with active board certification and unrestricted medical license in relevant states. The role involves performing detailed...SuggestedFull timeRemote workWork from home
ExamWorks
United States4 days ago - ...Dane Street, a certified "Great Place to Work" company is seeking a Physician to provide utilization review services for the Group Health Department. This role requires utilizing clinical expertise to review medical records and provide an interpretation of the medical...SuggestedRemote work
Dane Street
United States1 day ago $219k - $286.9k
...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
Phoenix, AZ3 days ago$230k
...simplify health care one person, one family and one community at a time. Company: Oak Street Health Title: Utilization Management Physician Reviewer Location: Fully Remote Hours: full time, Monday - Friday, 8am -5pm Salary: $230k per year Role...SuggestedHourly payFull timeLocal areaRemote workMonday to FridayCVS Health
United States4 days ago- ...A leading independent review organization is seeking a Utilization Management Physician Reviewer for a full-time remote role. Candidates must possess an active Nebraska medical license and have a minimum of 5 years clinical practice experience. Responsibilities include...SuggestedFull timeCasual workRemote workMonday to Friday
ExamWorks UM Strategies
United States3 days ago - ...CorroHealth is seeking a Medical Director, Concurrent Review, to evaluate hospitalizations nationwide. The role emphasizes using clinical... ...a predictable schedule and a path to expand knowledge in Utilization Review. Ideal candidates hold an MD/DO with an unrestricted...SuggestedRemote work
CorroHealth Inc
United States3 days ago - ...Humana Inc is seeking a Medical Director to lead inpatient medical necessity reviews and utilization management with a focus on quality and physician collaboration. The role leverages hospital medicine, critical care, or ED experience to assess complex cases and support...SuggestedRemote work
Humana
United States1 day ago - ...Utilization Review (UR) Specialist Location: Open to candidates near Wyomissing PA & Chadds Ford PA (Hybrid / Remote Eligible) Job Type: Full-Time Schedule: Monday – Friday Diversified Treatment Alternative Centers (DTAC) is seeking a detail-oriented and experienced...SuggestedFull timeRemote workMonday to FridayFlexible hours
Diversified Treatment Alternative Centers (DTAC)
Chadds Ford, PA1 day ago - ...Recovery Unplugged is seeking an experienced Utilization Review Specialist to join our team. This remote, part-time role focuses on obtaining and maintaining insurance authorizations, communicating with managed care organizations, and collaborating with clinical teams...SuggestedPart timeRemote workWeekend work
Recovery Unplugged
United States3 days ago $60k - $70k
...Bradford is more than a healthcare network; we are recovery communities for every stage of the journey. We are seeking a Utilization Review Specialist to add to our dynamic team! The Utilization Review Specialist plays a critical role in ensuring that healthcare services...SuggestedFull timePart timeWork at officeRemote workBradford Health Services
Birmingham, AL3 days ago$24 - $26 per hour
...Utilization Review Specialist – Behavioral Health (Remote) PHP/IOP | Full-Time | Monday–Friday, 9 AM–5 PM ET | $24–$26/hour About the Role Principles Recovery Center (PRC) are hiring a Utilization Review (UR) Specialist to manage insurance authorizations for adolescent...SuggestedFull timeRemote workMonday to FridayPrinciples Recovery Center
United States2 days ago$30 - $35 per hour
...back, and treating every individual with empathy and respect. POSITION SUMMARY: As a key member of the Northpoint team, the Utilization Review Specialist is a licensed professional who is responsible for ensuring that clinically appropriate care, discharge, and cost-...SuggestedFull timeTemporary workFor contractorsWork at officeRemote workMonday to FridayNorthpoint-Recovery-Holdings,-LL
Meridian, ID1 day ago- ...Northpoint Recovery Holdings, LLC is seeking a licensed Utilization Review Specialist to ensure clinically appropriate care, discharge planning, and cost-effective utilization across the treatment continuum. You will lead reviews of admissions, stays, discharges, and...SuggestedRemote work
Northpoint-Recovery-Holdings,-LL
United States1 day ago - ...Utilization Review Specialist – Join a Top 1% Workplace Are you looking for a fast-paced clinical role where your contributions are truly... ...clinical updates and managing authorizations. Collaborate with physicians, nurses, and therapists to ensure timely and complete...SuggestedWork at officeRemote work
KVC Missouri
Olathe, KS1 day ago $71.03k
...opportunities in a competitive industry. Come join our dynamic and dedicated team. Behavioral Health Prior Authorization Utilization Review Consultant Division of Fee for Service Management (DFSM) Job Location: Address: 150 North 18th Avenue Phoenix Arizona...Full timeContract workPart timeInternshipRemote workWork from homeFlexible hoursArizona Department of Administration
Phoenix, AZ6 days ago$30 - $45 per hour
...opportunity in Long Beach, CA. This role requires expertise in Medicaid and Medi-Cal operations, along with experience in Epic EHR and Utilization Review. The selected candidate will perform chart reviews, ensure documentation accuracy, and support Medicaid program metrics. This...Hourly payContract workRemote workPyramid Consulting
Long Beach, CA2 days ago$40k - $50k
...Description Utilization Review Specialist Full-Time- must be able to work a few weekends per month Location: Remote Preferred Residence: Candidates residing in Florida, Tennessee, Texas, Virginia, South Carolina, or New Jersey are strongly encouraged to apply. Job Details...Full timePart timeWork at officeRemote workWeekend workRecovery Unplugged
Fort Lauderdale, FL5 days ago$248.5k - $373k
...businesses, is seeking an internal medicine or family medicine physician to join our Utilization Management team. Optum is a clinician-led care... ...organizational determination processesParticipates in case review and medical necessity determinationMaintain proficiency in...Minimum wageFull timeWork experience placementWork at officeLocal areaRemote workWork from homeUnitedHealth Group
San Antonio, TX1 day ago- ...Bradford Health Services seeks an experienced Utilization Review Specialist to join our Birmingham-based team. You will evaluate patient records... ...regulatory compliance. You will collaborate with physicians, case managers, and insurers to obtain authorizations, monitor...Remote work
Addiction And Mental Health Services
United States4 days ago - ...Minnesota Adult & Teen Challenge in Minneapolis is seeking a Utilization Review Coordinator to obtain and maintain insurance authorizations for treatment services, collaborating with admissions, counselors, and payers to ensure timely approvals and compliance. This hybrid...Remote work
MnAdultTeenChallenge
Minneapolis, MN3 days ago - ...Comagine Health in Oregon is seeking a Supervisor, Clinical CM to provide operational supervision of clinical staff performing utilization reviews and specialty reviews using InterQual criteria. You will mentor reviewers, ensure medical necessity decisions are accurate,...Remote workFlexible hours
Comagine Health
United States4 days ago - ...Medix is seeking a highly skilled Utilization Review Nurse Specialist for a fully remote role in the United States. The RN will assess medical... ...necessity and level-of-care decisions, collaborating with physicians and payers to ensure appropriate care and revenue integrity....Remote work
Medix
United States3 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 workMonday to Friday
Optum
Tucson, AZ2 hours ago $34.82k - $55.99k
...The Utilization Review (UR) Intake Specialist provides staff support services including typing reports and correspondence, file handling and forms completion in addition to answering incoming telephone calls, supporting the goals of the Utilization Review / Case Management...Hourly payMinimum wageFull timeWork at officeLocal areaRemote workFlexible hours- ...WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure compliant patient care. The role emphasizes adherence to HIPAA, state and federal regulations, and a strong team-oriented environment...Work at officeRemote work
HealthHelp
United States1 day ago - ...Cleveland Clinic is seeking an Utilization Management RN Reviewer to support remote operations from home. The role covers admission and concurrent reviews, and ensures medical necessity criteria are applied to hospital stays and discharges. Qualifications include RN...Remote work
Cleveland Clinic
New York, NY5 days ago $69.39k - $88.61k
...Cincinnati Children’s is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports case management, authorization, compliance, and education within the Utilization Review department. The role requires a Bachelor...Full timeRemote workCincinnati Children's
United States1 day ago- ...Cleveland Clinic Health System is seeking an experienced Utilization Management RN Reviewer to work remotely with a focus on admission, concurrent and retrospective reviews. The role supports payer communications, data collection, and clinical decision-making to ensure...Work at officeRemote work
CCF
New York, NY4 days ago - ...accredited college or university in Nursing, Social Work, Behavioral Health or related field required preferred. ~2-3 years of utilization review experience in behavioral health, addiction treatment, or managed care. ~ Strong understanding of ASAM criteria, LOCUS, DSM-...Daily paidFull timeRemote work
