Average salary: $257,383 /yearly
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- ...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 - ...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 States4 days 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 - 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
United States3 days ago - ...manage the total cost of care. We are currently looking for a Physician Reviewer to join our growing team on a full time basis. The... ...case reviews, peer-to-peer discussions and education across utilization management, provider relations, and clinical #J-18808-Ljbffr...SuggestedRemote jobFull time
- 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
- ChenMed LLC seeks a physician with strong clinical and UM background to cover delegated utilization management across multiple territories. The role requires residency in... ...years in hospital medicine, with utilization review experience preferred. You will coordinate with...SuggestedRemote job
- tango is seeking a Physician Reviewer to join our remote, full-time team. You will perform real-time utilization management case reviews, apply evidence-based guidelines, and conduct peer-to-peer discussions with payers and physicians to determine medical necessity for...SuggestedRemote jobFull timeFlexible hours
- Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide accurate coverage determinations for inpatient and outpatient services, applying UM criteria, clinical judgment, and internal policies. You will coordinate with care teams to ensure...SuggestedRemote jobFull time
- ...To support Utilization Management operations, the full-time Utilization Review Medical Director will conduct clinical reviews of Durable Medical Equipment (DME) requests remotely, ensuring compliance with Medicare and Medicaid guidelines while maintaining productivity...SuggestedFull timeRemote work
Virtual Vocations Inc
United States1 day ago - WNS is seeking a clinically trained reviewer to perform utilization reviews and case management activities. The role requires RN or LVN/LPN licensure and at least two years in related functions, with strong knowledge of regulatory standards and insurance terminology. The...SuggestedRemote job
- ...ABOUT MRIoA Founded in 1983, Medical Review Institute of America (MRIoA)is a... ...(IRO) specializing in technology-driven utilization management and clinical medical review solutions... ...are currently seeking Board-Certified physicians in RADIOLOGY to conduct independent Utilization...SuggestedFull timeContract workFor contractorsRemote workFlexible hours
Medical Review Institute of America
Remotemore than 2 months 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
New York, NY2 days ago $99.7k - $168.81k
Position Summary: The Manager of Utilization Management provides daily oversight for Case Management teams (which includes RN’s, Social... ...timely authorizations related to pre-certification, concurrent review, referrals, and other plan services. - Develops and monitors...SuggestedFull timeTemporary workWork experience placementWork at officeWork from home- Integra Partners seeks an experienced Utilization Review Medical Director to lead clinical reviews of DMEPOS requests within a remote UM environment. You will ensure decisions meet Medicare/Medicaid guidelines and internal policies while maintaining timely throughput and...SuggestedRemote job
$150 per hour
The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment (DME) and related requests... ..., and regulatory requirements. This role is best suited for physicians who thrive in a process-driven environment and are committed...Hourly payFull timeContract workTemporary workPart timeLocal areaRemote workIntegra Partners
Troy, MIa month 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 processes Participates in case review and medical necessity determination Maintain...Minimum wageFull timeWork experience placementWork at officeLocal areaRemote workWork from homeSacbar
United States1 day 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 processes Participates in case review and medical necessity determination Maintain proficiency...Minimum wageFull timeWork experience placementWork at officeLocal areaRemote workWork from homeSt Cloud Orthopedics
United States1 day 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...Remote workMonday to Friday
Optum
Tucson, AZ4 days ago $50k
...lives of patients and their families What to Expect (Job Responsibilities) Complete pre-authorizations, concurrent reviews, and internal utilization review assessments Consult with the multidisciplinary treatment team to gather necessary information for concurrent...Remote workNurseRemotely
United States2 days ago$62k - $70k
...of this position is to ensure that the utilization process is thorough, organized and streamlined... ...manner Completes peer to peer reviews with insurance MDs to advocate for... ...territory. Common credentials include: Physicians: MD or DO (typically Board Certified in...Full timeLocal areaRemote workCharlie Health Outreach
United States5 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
- ...to ensure our client’s revenue cycle is managed in the most efficient and streamlined manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist will utilize his or her knowledge and skills to review clinical...Work at officeRemote workFlexible hours
Spectrum Billing Solutions
Skokie, IL4 days ago - ...Utilization Review Specialist Ethos Risk Services is a leading insurance claims investigation and medical management company committed... ...maintaining compliance with applicable regulations, supporting Physician Advisors with case materials and scheduling, and delivering...Full timeWork at officeRemote work
Ethos Risk Services
United States5 days ago - ...Utilization Review (UR) Specialist Location: Chadds Ford, Pennsylvania (Hybrid / Remote Eligible) Job Type: Full-Time Schedule: Monday – Friday Overview Diversified Treatment Alternative Centers (DTAC) is seeking a detail-oriented and experienced Utilization Review (UR...Full timeRemote workMonday to FridayFlexible hours
Diversified Treatment Alternative Centers (DTAC)
Chadds Ford, PA2 days ago - ...To support the Ethos Medical Management Team, the full-time Utilization Review Specialist will ensure the efficient and timely processing of... ...Request and organize additional medical documentation for Physician Advisors Ensure all work meets Client, State, Federal, and...Full timeWork at officeRemote work
Virtual Vocations Inc
United States1 day ago - ...Location: Exeter, NH/ South Burlington, VT/ Hybrid/ Remote Employment Status: Full-time FLSA Status: Non-Exempt Reports To: Utilization Review Process Manager Job Summary: Under the supervision of the Utilization Review Process Manager, the Utilization Review Specialist...Full timeWork at officeRemote work
Socket
Austin, TX1 day ago $35 - $40 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-effective...Full timeTemporary workWork at officeRemote workMonday to FridayNorthpoint-Recovery-Holdings,-LL
Meridian, ID1 day ago- Integra Partners, a national DMEPOS network administrator, seeks a remote Utilization Review Medical Director. You will conduct clinical reviews of DMEPOS requests, ensure determinations meet Medicare/Medicaid guidelines, and maintain high-quality documentation in a fast...Remote jobFull time
$213.1k - $383.58k
...the people and communities we serve. The Job The Utilization Management (UM) Physician Medical Director provides physician-level clinical leadership... ...for the organization's prior authorization, concurrent review, and appeals programs. This role serves as the clinical...Full timeFor contractorsWork at officeLocal areaRemote workRelocation
