Average salary: $259,600 /yearly
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- ...To support a growing healthcare practice, the contract-to-hire BCBA Licensed Utilization Review Specialist will perform prospective, concurrent, and retrospective reviews of Applied Behavior Analysis (ABA) services, ensuring medical necessity and appropriateness while...SuggestedContract workRemote work
Virtual Vocations Inc
United States3 days ago - ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to ensure accurate coverage determinations for inpatient and outpatient services. The role involves collaborating with care teams and making utilization management decisions based on clinical...SuggestedFull timeRemote work
Hispanic Alliance for Career Enhancement
Springfield, IL3 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...SuggestedPrice workExtra incomeFor contractorsRemote workFlexible hours
Dane Street
United States4 days ago - ...IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The role involves reviewing medical necessity... ...offers a collaborative environment with opportunities to leverage clinical expertise in utilization management. #J-18808-Ljbffr...SuggestedRemote work
IntePros
New York, NY2 days ago $174.07k - $374.92k
...simplify health care one person, one family and one community at a time. Company: Oak Street Health Title: Full-Time Utilization Management Physician Reviewer Location: Remote/ Treehouse Role Description: This full-time role is responsible for provisioning accurate and...SuggestedHourly payFull timeLocal areaRemote workOak Street Health
Springfield, IL5 days ago- ...A healthcare management organization is seeking experienced Physician Reviewers to join their Medicare Utilization Management team in a remote position. Responsibilities include reviewing clinical service requests, applying evidence-based guidelines, and collaborating...SuggestedRemote work
Solving IT
New York, NY2 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 DC4 days ago - ...Brighton Health Plan Solutions is seeking an Utilization Management Nurse to perform medical necessity and benefit reviews remotely. The role requires current LPN licensure and expertise in CMS/MCG criteria with experience in inpatient/outpatient reviews. The successful...SuggestedRemote work
Brighton Health Plan Solutions
Chapel Hill, NC4 days ago - ...Utilization Physician Reviewer At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians...SuggestedReliefRemote workShift workWeekend work
- ...highly skilled Medical Director to join our growing team. This pivotal role will be responsible for overseeing and performing utilization reviews, prior authorizations, and making crucial medical necessity determinations. The Medical Director will serve as a key clinical...SuggestedFull timeRemote workFlexible hours
VALID8 Financial
Austin, TX2 days ago - ...Medical Director, Utilization Management The Medical Management team ensures that Blue Shield is on the cutting... ...you will deliver and collaborate on clinical review activities, which includes management of the physician processes in support of utilization management and...SuggestedFull timePart timeWork at officeLocal areaWork from homeHome office2 days per week
Blue Shield Of California
Lodi, CA1 day ago - ...patients-we invest in our people. About the Role: The Utilization Review Specialist plays a critical role in ensuring that healthcare... ...for collaborating with multidisciplinary teams, including physicians, nurses, and insurance representatives, to gather necessary...SuggestedPart timeRemote work
ADDICTION AND MENTAL
United States3 days ago - ...Utilization Review Specialist The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to... ...essential for collaborating with multidisciplinary teams, including physicians, nurses, and insurance representatives, to gather necessary...SuggestedRemote work
Bradford Health Services
United States2 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, AZ1 day ago - ...Working remotely in a full-time capacity, the Behavioral Health Utilization Review Specialist will manage the authorization of treatment through insurance and managed care companies, performing pre-certification, concurrent, and appeal reviews while ensuring compliance...SuggestedFull timeRemote work
Virtual Vocations Inc
United States2 days ago - ...Seeking a confident and detail-oriented Utilization Review Specialist, the full-time remote position will involve reviewing clinical documentation, managing insurance authorizations, and collaborating with providers to ensure timely care for clients in a behavioral health...Full timeRemote work
Virtual Vocations Inc
United States3 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, CA4 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 processes Participates in case review and medical necessity determination Maintain...Minimum wageFull timeWork experience placementWork at officeLocal areaRemote workWork from homeUnitedHealth Group
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
$1,848 per week
...American Traveler is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Baltimore, Maryland. Job... ...written communication skills required to interact with enrollees, physicians, facility staff, and management Ability to negotiate and...Local areaRemote workMonday to FridayShift workAmerican Traveler Staffing Professionals
Baltimore, MD3 hours ago- Coronis Health is seeking a remote Utilization Review Specialist to manage treatment authorization for behavioral health and substance abuse, interfacing with insurance and managed care entities. The role covers pre-certification, concurrent reviews, and appeals with a...Remote job
$29.62 - $45.31 per hour
...Responsibilities 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 Investigate, review, and prepare all requests for prior authorization...Minimum wageFull timeWork experience placementLocal areaRemote workShift workProvidence Health & Service
Oregon, WI4 days ago- ...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
$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 reviews...Remote job- ...Ophthalmologist Telecommute Medical Review Stream Physician Location US-LA-New Orleans Job ID 342758 Pos. Type... ...RESPONSIBILITIES: Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness...Contract workTemporary workFor contractorsLocal areaRemote workMonday to FridayFlexible hours
Concentra
United States1 day ago $219k - $286.9k
...Job Description Job Description 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....Full timeLocal areaRemote workWork from homeHome officeWeekend work$30 - $34 per hour
A healthcare services company is seeking an experienced Utilization Review Nurse to work remotely. The ideal candidate must hold an active LVN license in California and have experience in outpatient utilization management. Responsibilities include approving or denying...Hourly payRemote workAstrana Health
California, MO5 days ago$223.8k - $313.1k
A leading healthcare company in New Jersey seeks a Medical Director to perform clinical reviews of inpatient medical records and assess medical necessity. Candidates should possess an MD or DO with at least 5 years of post-residency clinical experience and be ready to work...Remote 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...Remote jobFull timeContract workFor contractorsFlexible hours
- ...dedicated to community health and social services, is hiring a Physician, Medical Document Review. This pivotal role focuses on reviewing clinical... ...policies and procedures that uphold program standards. Utilize software systems such as SEAMS, EPIC, PSYCKES, Bronx...Work at officeRemote workFlexible hours
Tal Healthcare
New York, NY3 days ago
