Average salary: $257,383 /yearly
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- ...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 the health...SuggestedRemote work
Vivo HealthStaff
New York, NY12 days ago - Medical Review Institute of America (MRIoA) seeks Board-Certified Family Medicine physicians to perform independent Utilization Reviews. This flexible, fully remote 1099 contractor role requires 1-2 hours per week with no minimum commitment. Applicants must hold an MD/DO...SuggestedRemote jobFor contractorsFlexible hours
- ...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 States4 days ago $219k - $286.9k
...Physician Reviewer - Utilization Management 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...SuggestedFull timeLocal areaRemote workWork from homeHome officeWeekend workOscar Health
United States1 day ago$174.07k - $374.92k
...Full-Time Utilization Management Physician Reviewer We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate...SuggestedHourly payFull timeRemote workAvery Healthcare Group Ltd.
United States4 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 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
$219k - $286.9k
Oscar Health is hiring a Physician Reviewer to join our Utilization Management team. You will determine the medical appropriateness of inpatient, outpatient, and pharmacy services by reviewing clinical information and applying evidence-based guidelines. This remote role...SuggestedRemote jobWork from home- 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...SuggestedRemote jobFull timeCasual workMonday to Friday
- 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 job
- 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...SuggestedRemote jobFull timeWork from home
- 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
- 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,...SuggestedRemote jobFor contractorsMonday to FridayFlexible hours
- ChenMed LLC is seeking a Physician Reviewer to lead delegated utilization management (UM) reviews across multiple markets. You will establish daily case counts, attend essential calls with health plans, advise other reviewers, and participate in ongoing process and quality...SuggestedRemote job
- 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
- ...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...Full timeContract workFor contractorsRemote workFlexible hours
Medical Review Institute of America
Remotea month ago - ...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...Full timeRemote work
Virtual Vocations Inc
United States5 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...Remote job
- 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...Remote job
- Devoted Health is seeking a Clinical Guide on our Outpatient Utilization Management team to review outpatient authorization requests using evidence-based criteria and CMS requirements. You will help ensure appropriate care settings and support members navigating the healthcare...Remote jobFull time
- A healthcare organization is seeking Board-Certified physicians in Oncology for a flexible, remote utilization review role. This position requires a Medical Degree (MD or DO) with a current license in Florida, Minnesota, or Oregon, and an active Board Certification in...Remote jobFlexible hours
- Rheumatology (MD/DO) Utilization Review - Remote Contract (1099) Apply for this independent contractor position with Medical Review Institute... .... The Opportunity We are seeking board‑certified physicians in rheumatology to conduct independent utilization reviews....Remote jobContract workFor contractorsFlexible hours
- ...York, seeks experienced Board-Certified Orthopedic Surgeons for a fully remote, non-clinical position. Qualified physicians will conduct Utilization Reviews, providing objective, evidence-based opinions on treatment requests. Responsibilities include reviewing medical records...Remote jobExtra income
- ...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...Remote work
CorroHealth Inc
New York, NY1 day ago - ...who want to be part of our mission and join our team! As a Utilization Review Nurse, you will utilize your critical thinking skills, clinical... ...process Provide information by responding to queries of physicians and their practice staff, sorting and distributing messages...Remote jobLocal area
$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 home- Comagine Health is seeking a Clinical Utilization Review Nurse (RN) for a remote, full-time role based primarily in Alabama. You will assess medical necessity and quality of care through prospective, concurrent, and retrospective reviews, ensuring compliance with clinical...Remote jobFull timeContract work
$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, MI9 days ago$80 per hour
...healthcare professionals experienced in prior authorization, utilization management, clinical review, medical necessity criteria, payer authorization... ...especially valuable depending on project scopeExperience in physician office, hospital, health system, payer, managed care,...Hourly payPart timeFor contractorsWork at officeRemote workFlexible hours24-MAG LLC
New York, NY4 days ago- ...ABA Utilization Review Specialist Spectrum Billing Solutions offers industry-leading revenue cycle management services for healthcare providers. Our team has deep industry knowledge, technology, and experience to ensure our client's revenue cycle is managed in the...Work at officeRemote workFlexible hours
Spectrum Billing Solutions
United States1 day ago
