Average salary: $126,756 /yearly
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- Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient services, ensuring treatment aligns with clinical guidelines, regulatory requirements, and patient needs. This role requires reviewing provider requests, gathering necessary medical...SuggestedRemote workMonday to FridayFlexible hoursWeekend work
- ...admission through discharge. Serves as liaison to on-site external reviewers. Uses Midas for recording reviews and tracking denials. Adds... ...in applicable field of study required Six months psychiatric utilization review either for hospital or external review organization...SuggestedLocal areaFlexible hours
$90.87 - $154.33 per hour
A healthcare organization is seeking a remote Physician Clinical Reviewer with a DO, MBBS, or MD qualification and over 5 years of clinical experience. This role involves critical case reviews and discussions with healthcare providers. Candidates will be responsible for...SuggestedRemote job$90.87 - $154.33 per hour
A health services company is seeking a remote Physician Clinical Reviewer specializing in dermatology. The ideal candidate will provide medical review of service requests, discuss cases with physicians, and ensure proper documentation of communications. This role requires...SuggestedRemote job- A leading medical review company in Washington is seeking a Utilization Management Nurse Reviewer. The role involves assessing medical necessity, reviewing patient records, and collaborating with healthcare providers to optimize care. Candidates must have a valid nursing...SuggestedRemote job
- 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
$23.08 - $37.02 per hour
A healthcare services provider is seeking an Initial Review Pharmacy Technician in Washington, DC to play a vital role in managing pharmacy initiatives. Responsibilities include reviewing patient information, making approval recommendations for medication requests, and...Suggested- A leading healthcare solutions provider is seeking a Clinical Care Reviewer to evaluate medical necessity for inpatient and outpatient services. This role involves reviewing provider requests, making determinations based on clinical guidelines, and collaborating with healthcare...SuggestedRemote job
$90k - $100k
...nonprofit treatment provider in Washington D.C. seeks a Clinical Review Clinician to oversee the clinical review process for substance... ...’s degree, active DC licensure, and extensive experience in utilization management. This full-time position offers competitive...SuggestedFull time$18 - $20 per hour
A leading claims management company in Washington is seeking a Utilization Review Coordinator. This role involves assigning utilization review requests, verifying data, and supporting clinical staff. Ideal candidates should have administrative experience, preferably in...Suggested- A healthcare staffing agency is seeking a travel nurse RN specializing in Utilization Review for a position in Washington, DC. The role offers a travel employment type with 40 hours of work each week and 8-hour day shifts. The contract is for a duration of 13 weeks, starting...SuggestedContract workFlexible hoursDay shift
$2,326 per week
Job Overview Access Healthcare is seeking a travel nurse RN Utilization Review for a travel nursing job in Washington, District of Columbia. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 05/11/2026 Duration: 13 weeks 40 hours...SuggestedShift work$52.26 per hour
...Description The Utilization Review (UR) Nurse has a strong clinical background blended with a well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports the UM program by developing...SuggestedMinimum wageFull timeLocal areaShift work- ...Certified Orthopaedic Spine Surgeon, Neurosurgeon, Neurologist, and Physical Medicine & Rehabilitation physician to process utilization reviews. Work's Compensation experience is preferred but not required. This telework opportunity provides the ability to customize your...SuggestedFor contractorsRemote workMonday to Friday
- Start date: ASAP Shift:5x8 Days Monday-Friday Years of Experience Required: 1 year First-timers accepted: Yes Weekends Required: No Certs Required: BLS, WA RN License Will this traveler need to float between like units? No Locals accepted? No. Pending License accepted:...SuggestedLocal areaImmediate startRemote workMonday to FridayShift workWeekend work
- ...Job Title: Registered Nurse - Utilization Review Location (On-site, Remote, or Hybrid?): Everett, WA (onsite) Contract Duration: 13 weeks Working hours:Day 5x8-Hour (08:00 - 16:30) Total hours: 40 Start date: ASAP Shift:5x8 Days Monday-Friday Years...Contract workLocal areaImmediate startRemote workMonday to FridayShift workWeekend work
$90k - $100k
...Meaningful Work Picture Yourself at Gaudenzia as a Clinical Review Clinician at our R.A.P. Program located in Washington D.C.! We... ...master's level, licensed, clinician, with documented experience in utilization review, management, and quality assurance skills! Are you...Full timeFlexible hoursWeekend work- Hmong Chinese Language Document Reviewer Employment Type: Full Time, Mid-Level Department: Legal As a CGS Hmong Chinese Document Reviewer... ...; Produces a variety of written documents and materials utilizing a wide range of office software applications; Establishes and...Full timeWork at officeFlexible hours
$50 - $60 per hour
We are looking for a Clinical Reviewer to join our team to train AI models. You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of each model. Physicians & Advanced Practice Clinicians Physicians of all...Hourly payFull timeContract workPart timeRemote work$23.08 - $37.02 per hour
...build the future of pharmacy with us. Job Posting Title Initial Review Pharmacy Technician Job Description Plays a key role in... ...revenue goals and operational objectives. Responsible for executing utilization management programs on behalf of health plan/payor customers,...Work at officeLocal areaVisa sponsorshipWork visa$210k - $260k
...an alternative application process. Director - Internal Credit Review Full-time Regular Director District of Columbia, Washington, DC... ...operating segment (Farm & Ranch, Corporate AgFinance, Power & Utilities, Broadband Infrastructure, and Renewable Energy). Oversee design...Full timeContract workWork at officeFlexible hours- Join our Team as a Utility Manager! Are you ready to play a critical role in large, exciting projects critical to improving infrastructure... ...in the District of Columbia. The role combines technical review, practical field perspective, coordination, and process tracking...Full timeFor contractorsH1bWork at office
- Join our Team as a Utility Engineer! Are you ready to play a critical role in large, exciting projects critical to improving infrastructure... ...in the District of Columbia. The role combines technical review, practical field perspective, coordination, and process tracking...Full timeFor contractorsH1bWork at office
- We are passionate about bringing cool, authentic restaurants to airports that reflect a taste of place. Our Utility/Dishwasher positions at SSP have the very important role of keeping our restaurants and units clean and sanitized for both our guests and our team. Things...Local area
$18.7 - $32.72 per hour
...Family Choice is seeking a detail-oriented and customer-focused Utilization Management Coordinator to provide essential administrative and... ...Responsibilities Manage Authorization Intake & Documentation Review and screen incoming clinical documents; build shells for...Work at office$89.07k - $162.8k
...services, procedures and facilities. Responsible for clinical review of acute care services based on Medically Necessity criteria the... ...system per Clinical Operations department's policy. Monitors utilization of all services for fraud and abuse. Performs pre-...Contract workWork at office- Mental Health Reviewing Consultant (Bid) General information Date Wednesday, February 25, 2026 City Remote Country United States... ...hiring protocols to ensure accurate and defensible assessments. Utilize understanding of Office of Personnel Management (OPM) hiring policies...Minimum wageFull timeContract workTemporary workWork experience placementWork at officeRemote work
- A healthcare consulting firm is seeking Physician Reviewers/Advisors for a telework opportunity. This role allows physicians to utilize their clinical expertise to review medical records and provide professional opinions on disability applications. The position offers flexible...Remote jobExtra incomeFlexible hours
$90.87 - $154.33 per hour
A healthcare benefits company is seeking a Physician Clinical Reviewer for a remote position. This role is a key member of the utilization management team, providing medical reviews and interacting with healthcare professionals. Candidates must possess a DO, MBBS, or MD...Remote job$90.87 - $154.33 per hour
...driven career? Come build the future of pharmacy with us. Job Posting Title Physician Clinical Reviewer - Dermatology- REMOTE Job Description Key member of the utilization management team, and provides timely medical review of service requests that do not initially...Remote jobWork at officeLocal areaVisa sponsorshipWork visa