Average salary: $275,000 /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...SuggestedRemote job
Vivo HealthStaff
Carteret, NJ15 days ago - Overview We are seeking a high‑performing Physician Reviewer to join our Group Health division. The role is responsible for delivering timely, defensible utilization review determinations across a high-volume, fast-paced environment. Reviews span multiple case types, including...SuggestedFull timeTemporary workWork at officeRemote workWork from homeMonday to FridayNight shift
- Greenkey Resources LLC is hiring a remote Clinical Reviewer based in Arizona. In this role, you'll review medical appropriateness and... ...clinical determinations. If you hold an MD and have experience in utilization review, this position invites you to be part of a...SuggestedRemote job
$211.2k - $277.2k
...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....SuggestedFull timeLocal areaRemote workWork from homeHome officeWeekend workOscar Health
New York, NY12 days ago- ...Orthopedic Surgeon Utilization Review Opportunity Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers. We are currently seeking Board-Certified Orthopedic Surgeons with an active New York medical...SuggestedPrice workExtra incomeFor contractorsRemote workFlexible hours
Dane Street
United States4 days ago - ...for a faculty or staff position, please review this tip sheet. The University of Miami has a great opportunity for a Nurse Utilization Review Supervisor to work at UTower.... ...Coordination staff when experiencing family/physician issues and attempt to resolve such issues...SuggestedFull timeTemporary workRemote workWorldwideNight shiftWeekend work
The University of Miami
United States5 days ago $174.07k - $374.92k
...divh2Full-Time Utilization Management Physician Reviewer/h2pWere building a world of health around every individual shaping a more connected, convenient and compassionate health experience. At CVS Health, youll be surrounded by passionate colleagues who care deeply, innovate...SuggestedHourly payFull timeRemote work$6,377.5 - $10,785.83 per month
...career advancement and more. Explore more details on the Benefits of Working at HHS webpage. Functional Title: Acute Care Utilization Review (ACUR) Clinical Lead Job Title: Nurse IV Agency: Health & Human Services Comm Department: UR Acute Care FTE 50 Posting...SuggestedFull timeTemporary workPart timeWork at officeRemote workShift workDay shift3 days per weekTexas Health and Human Services Commission
Austin, TX1 day ago$250k
...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...SuggestedFull timeTemporary workLocal areaRemote workIntegra Partners
Troy, MI3 days ago$105 - $115 per hour
EPITEC is seeking a Physician Reviewer to evaluate clinical service requests and utilize medical expertise for decision-making. The role is non-patient-facing and involves supporting utilization management processes and participating in quality improvement initiatives....SuggestedRemote jobHourly payFlexible 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....SuggestedRemote 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...SuggestedRemote jobExtra income
- ...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
- ...elevate outcomes, and love your Mondays as the Nurse Director Utilization Review and Case Management at an award winning hospital in the Bay... ..., and readmission reduction—uniting social work, nursing, physicians, and ancillary teams to elevate every transition of care at...SuggestedRemote workWeekend work
Clinical Management Consultants
Berkeley, CA1 day 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 job
- ...Director to conduct inpatient medical necessity reviews while collaborating with healthcare providers. This role requires a physician with at least 5 years of post-residency... ...performing clinical reviews, providing utilization management determinations, and ensuring compliance...Remote jobMonday to Friday
$234.63k - $336.6k
...California (BSC) is on the cutting edge of utilization management reimagined to accelerate the... ...– Commercial Prior Authorization Review will report to the Senior Medical Director... ...activities, which includes management of the physician processes in support of utilization...Full timePart timeWork at officeLocal areaWork from homeHome office2 days per weekBlue Shield Of California
El Dorado Hills, CA1 day ago$60k - $75k
...Billing Solutions delivers hands-on, process-driven operational support to behavioral health programs. We are looking for a Utilization Review (UR) Specialist in Boca Raton, FL Compensation: $60,000 - $75,000 a year - (Based on experience) Full-time Why Join...Full timeWork at officeRemote workQuadrant Health Group
Dania Beach, FL4 days ago- ...benefits package. This is an interim non-direct service position with an end date of: 12/31/2026. The Interim Nurse Case Manager Utilization Review Nuse II is a professional role that will utilize clinical skills to help navigate the multifaceted healthcare system. This...Interim roleWork at officeMonday to FridayFlexible hours
State of Vermont
Waterbury Center, VT4 days ago - ...Senior Utilization Review Specialist Within Health is revolutionizing eating disorder treatment through our innovative telehealth platform. We provide remote clinical services at the Partial Hospitalization Program (PHP) and Intensive Outpatient Program (IOP) levels...Work at officeRemote workWork from homeShift work
Within Health
United States6 hours ago - Harris Health System, Inc. is seeking a Utilization Management Review Nurse (UMRN) in Bellaire, TX. This position involves evaluating medical service... ...in patient care, handling appeals and collaborating with physicians. Required qualifications include a Bachelor’s in Nursing...Remote jobFlexible hours
- Overview Nurse Manager Case Management and Utilization Review opportunity at an award winning hospital in Southern Arizona, lead bold improvements... ...excellence. Partner closely with social work, pharmacy, and physician advisors to streamline denials prevention, optimize length...Work from homeRelocation package
$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 States3 days ago- We are seeking Senior Virtual Utilization Review Specialists to work in Pacific Time and Mountain Time zones. The role is remote with a weekday... ..., and quality/revenue integrity work, collaborating with physicians, payors, and the financial clearance center. They must hold...Work at officeRemote workRotating shiftWeekday work
- ...1. Supervise licensed and non-licensed denial unit staff, managing daily tasks, performance reviews, and disciplinary actions. 2. Collaborate effectively with physician reviewers, medical directors, and other departments. 3. Ensure prompt responses to requests and...Permanent employmentTemporary workRemote work
Vivo HealthStaff
Burbank, CA28 days ago $55k - $70k
Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote Salary $55K - $70K Who We Are Exact Billing Solutions is a unique team of revenue‑cycle management professionals specializing in the substance use disorder, mental...Work at officeRemote workFlexible hours- Utilization Review (UR) Specialist Position Title: Utilization Review Specialist Department: Clinical / Billing Operations Reports To: Executive Director & Clinical Director FLSA Status: Full-Time, Salaried Location: Dove / Robin Recovery Facilities Salary Range:...Full timeRemote work
$93.12k - $167.62k
United Cerebral Palsy of Georgia is looking for a Psychologist Reviewer - ABA to work virtually and collaborate with medical directors... ...an active license to practice. Candidates will ensure proper utilization of plan benefits and mentor staff. The position offers a salary...Remote job- Dove Recovery is seeking a Utilization Review Specialist responsible for managing authorization and review activities for clients. The position requires collaboration with clinical and billing teams to ensure compliance with documentation standards for timely authorizations...Remote jobFull time
- Overview Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote About Exact Billing Solutions Exact Billing Solutions is a unique team of medical billing professionals specializing in the substance use disorder, mental...Work at officeRemote workFlexible hours
