Average salary: $275,000 /yearly
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$275k - $300k
...5,000-$300,000) Full benefits: health, vision, dental, vacation, CME, PTO Requires 5+ years experience in Medicare Advantage Utilization Review/Utilization Management and an active unrestricted CA license ASAPstart date Sacramento is the state's capital andhas over 450...SuggestedPermanent employmentFull timeRemote workWork from homeMonday to FridayIntegrity Healthcare
Sacramento, CA2 days ago- ...psychiatrist with experience doing UR/IRO work to join our physician panel to review adult and pediatric psychiatric cases for healthcare plans... ...for those on their physician panel to easily perform utilization reviews. The volume of behavioral health cases is rising,...SuggestedFull timePart timeLocal areaHome office
RediMinds Inc
New York, NY2 days ago $248.5k - $373k
...deliver clinical coverage and medical claims reviews. Our role is to empower providers and... ...costs. The Medical Director provides physician support to Enterprise Clinical Services... ...application of clinical knowledge in various utilization management activities with a focus on...SuggestedRemote jobMinimum wageWork experience placementLocal area- .... ABOUT MRIoA Founded in 1983, Medical Review Institute of America (MRIoA) is a nationally... ...(IRO) specializing in technology‑driven utilization management and clinical medical review... ...Sports Medicine/Family Medicine physician to assist in Utilization Review work, which...SuggestedFor contractorsRemote workWork from homeFlexible hours
- A leading medical review organization is seeking a Board-Certified Sports Medicine/Family Medicine physician for a remote Independent Contractor role. The physician will perform utilization review work, ensuring healthcare services are necessary and compliant. Responsibilities...SuggestedRemote jobFor contractors
- ...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 States15 hours ago - ...Physician Reviewer – Utilization Management (Remote)-Full Time Overview We are seeking a Board-Certified Physician to support utilization management activities by reviewing clinical documentation and determining the medical appropriateness of inpatient, outpatient, and...SuggestedFull timeLocal areaRemote workWeekend work
Medix
New York, NY4 days ago $28.41 - $43.47 per hour
...Prior Authorization (PA) Department Coordinate and execute the review and research functions required to support the PA Department... ...empower them. Providence Health Plan is calling an Associate Utilization Review Specialist who will: Be responsible for all core functions...SuggestedRemote jobMinimum wageFull timeWork experience placementShift work- A recognized Independent Review Organization is seeking a Board-Certified Psychiatrist for a fully remote role conducting Utilization Reviews. Candidates should have an active New York medical license and Workers’ Compensation Board Certification. Responsibilities include...SuggestedRemote jobExtra incomeFlexible hours
- Physician Advisor Utilization Review (MD/DO) Fairfax, VA, United States Job Identification: 679376 Posting Date: 02/23/2026, 07:50 PM Job Schedule: Part time Locations: Inova Fairfax Hospital Inova Fairfax Medical Campus is looking for a dedicated physician advisor...SuggestedPart timeRemote workFlexible 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
- About Dane Street Dane Street is a leading Independent Review Organization (IRO) and national provider of Utilization Review services. As we continue to expand our physician panel, we’re offering flexible, remote opportunities for board-certified physicians seeking supplemental...SuggestedExtra incomeFor contractorsRemote workFlexible hours
- A healthcare technology company is seeking a Clinical Care Manager to advance patient-centered care through precise Utilization Review. This role demands clinical expertise to evaluate healthcare services while ensuring compliance and effective care coordination. Candidates...SuggestedRemote job
- A healthcare company is seeking a Clinical Care Manager to advance high-quality, patient-centered care through Utilization Review. The ideal candidate will have an active RN license in Illinois and 5+ years of diverse healthcare experience. Responsibilities include evaluating...SuggestedRemote job
- A healthcare administration company seeks a Utilization Management Nurse to perform medical necessity reviews while working remotely. The ideal candidate will be an active Licensed Practical Nurse (LPN) with strong proficiency in the Utilization Review process. Responsibilities...SuggestedRemote job
$33 - $38 per hour
A healthcare solutions company is hiring Remote Clinical Review Nurses in Houston. The role involves reviewing cases for medical necessity... ...team. Candidates should have 3+ years of experience in utilization management and possess an Active RN Compact License. This is a...Remote job- ...Board-Certified Orthopedic Spine Surgeons for a fully remote, non-clinical role in Utilization Review. This opportunity offers flexibility and supplemental income, allowing physicians to provide evidence-based opinions on treatment requests without direct patient interaction...Remote jobExtra income
- A leading healthcare provider is searching for a Medical Director to support the Medical Management staff with utilization reviews, appeals, and pharmacy oversight. This role requires an MD or DO with at least 3-5 years of clinical experience and a current medical license...Remote jobFull timeWork from home
- 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
- ...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...Remote workWeekend work
Clinical Management Consultants
Berkeley, CA2 days ago $35 - $45.94 per hour
Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review 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...Hourly payFull timeRemote workWork from homeHome office- A leading health insurance provider is hiring a Utilization Review Nurse to perform case reviews and make care recommendations. Responsibilities include reviewing medical necessity and applying clinical guidelines. Candidates must have an active RN license, a nursing degree...Remote job
- ...Medicine and Sciences (CDU), DHS hospitals are training sites for physicians completing their Graduate Medical Education in nearly every... ...and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of the...Work at officeShift workNight shiftAfternoon shift
- ...Psychiatrist Physician Reviewer - PRN - Remote (Within Illinois) Acentra Health exists to empower better health outcomes through technology... ...to operations relating to the peer review process, utilization review activities, and other activities requiring clinical...ReliefLocal areaRemote work
Acentra Health
Downers Grove, IL2 days ago - Fresno County Department of Behavioral Health invites applications for the position of Utilization Review Specialist . Incumbents provide professional services including regulatory interpretation and guidance, review of health records, policies, and facilities to ensure...Full timeWork experience placementWork at office
- A healthcare organization is seeking a Physician Clinical Reviewer specializing in Dermatology to join their utilization management team. This remote role involves reviewing medical service requests, collaborating with healthcare professionals, and ensuring compliance with...Remote job
- A leading health organization is seeking an Associate Utilization Review Specialist to coordinate prior authorization reviews in a remote setting. The role demands a Bachelor's degree in a health-related field or equivalent experience in healthcare. Responsibilities include...Remote job
$18 - $20 per hour
...therapeutic programs located in Utah. We have 25+ years of experience using evidence-based practices to help families heal. As our Utilization Review Specialist, you will be responsible for maintaining organizational compliance and following all HIPAA regulations while...Full timeRemote workHome office$90.87 - $154.33 per hour
A healthcare company is seeking a Physician Clinical Reviewer - Dermatology to join their utilization management team. This remote position involves reviewing medical service requests, interacting with physicians, and providing clinical justifications for appeals. The ideal...Remote job- A leading pharmacy benefits manager is seeking a Physician Clinical Reviewer specialized in Dermatology for a remote role. This position involves... .... This is an opportunity to contribute to effective utilization management processes while working within a supportive team...Remote job
