Top 153 Utilization review physician Jobs in Remote

Medical Director-Board Certified in Psychiatry-MD or DO
The Maxis Group —Remote
- $50 - $170 an hour
- Part-time
- Remote
- Background check
- Medicine
- Psychiatry
Quick Apply
Assistant Medical Director
Medical Mutual of Ohio —Ohio
- Remote
- Medicine
- 5 years
- Word processing
- Health savings account
- Disability insurance
Regional Medical Director- (Philadelphia/Baltimore)
CareAllies —Philadelphia, PA
- $191,500 - $355,600 a year
- Full-time
- Remote
- Medicine
- 3 years
- Analysis skills
- Paid parental leave
- Paid holidays
1d
Physician Reviewers - Multiple remote opportunites available
ezURs —Remote
- $65 - $200 an hour
- Urgently hiring
- Remote
- Medicine
- Psychiatry
- BC/BE
- Flexible schedule
Quick Apply
Medical Director Behavioral Health, Medicaid
Humana —Raleigh, NC
- $223,800 - $313,100 a year
- Weekends as needed
- Remote
- Medicine
- Psychiatry
- 5 years
- Paid parental leave
- Paid holidays
2d
Physician Reviewer
MedReview —Remote
- $230,000 a year
- Full-time
- Remote
- Medicine
- 5 years
- BC/BE
Quick Apply
Board-Certified Physician for Disability Appeal Reviews
Emperion —Remote
- Part-time
- Remote
- Physical & Rehabilitation Medicine
- Mid-level
- Neurology
Quick Apply
Medical Director/ Physician Reviewer
MedReview —Remote
- $220,000 - $230,000 a year
- Full-time
- Remote
- Medicine
- Computer literacy
- BC/BE
- Commuter assistance
- Health insurance
Quick Apply
Rheumatology - Utilization Review - Remote- 1099 (contract)
MRIoA —Remote
- Part-time
- Remote
- Medicine
- 5 years
- HIPAA
Quick Apply
Gastroenterology (MD/DO) Utilization Review - Remote - Contract (1099)
MRIoA —Remote
- Part-time
- Remote
- Medicine
- 5 years
- HIPAA
Quick Apply
Remote Physician | Medical Director | Utilization Management
Medix —New York State
- $150 - $200 an hour
- Urgently hiring
- Remote
- Background check
- Medicine
- BC/BE
Quick Apply
5d
Medical Director Behavioral Health, Medicaid
Humana —Remote
- $223,800 - $313,100 a year
- Weekends as needed
- Remote
- Medicine
- Psychiatry
- 5 years
- Paid parental leave
- Paid holidays
2d
Behavioral Health Medical Director
Humana —Louisiana
- $223,800 - $313,100 a year
- Full-time
- Remote
- Medicine
- BC/BE
- Travel
- Paid parental leave
- Paid holidays
Medical Director Behavioral Health, Medicaid
Humana —Raleigh, NC
- $223,800 - $313,100 a year
- Weekends as needed
- Remote
- Medicine
- Psychiatry
- 5 years
- Paid parental leave
- Paid holidays
2d
Medical Director Behavioral Health, Medicaid
Humana —Louisiana
- $223,800 - $313,100 a year
- Weekends as needed
- Remote
- Medicine
- Psychiatry
- 5 years
- Paid parental leave
- Paid holidays
2d
PAS Physician Advisor (Level of Care / Admission Status Review)
R1 RCM, Inc. —Remote
- $150,075.00 - $199,070.29 a year
- Weekends as needed
- Medicine
- Computer literacy
- BC/BE
Dermatology Utilization Review - Remote - Contract (1099)
MRIoA —Remote
- Part-time
- Remote
- Medicine
- 5 years
- HIPAA
Quick Apply
Remote - Radiologist Utilization Review - 1099 (contract)
MRIoA —Remote
- Part-time
- Remote
- Medicine
- 5 years
- HIPAA
Quick Apply
Oncology Utilization Review - Remote - 1099 (contract)
MRIoA —Remote
- Part-time
- Remote
- Medicine
- 5 years
- BC/BE
Quick Apply
Endocrinologist - Independent Reviewer for Disability Appeals
Emperion —Remote
- $100 - $1,000 an hour
- Part-time
- Remote
- Mid-level
- 3 years
- Communication skills
Quick Apply

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utilization review physician jobs near remote

Medical Director-Board Certified in Psychiatry-MD or DO

The Maxis Group
Remote

Quick Apply

Job Details

Part-time
$50 - $170 an hour

Qualifications

Board Certification in Psychiatry
Doctor of Medicine
Utilization review
Psychiatry
Clinical psychiatry
CMS
CMS regulatory compliance
Utilization management
Clinical documentation
Resource utilization in healthcare
Health information regulatory compliance
Doctor of Osteopathy
Medical License

Full Job Description

Medical Director-Board Certified MD or DO in Psychiatry

Large Managed Care Compnay

DIRECT PLACEMENT OPPORTUNITY - THE PHYSICIAN WILL BE DIRECTLY CONTRACTED WITH AS A 1099.

Preferred M - F including Saturdays. 20 hours minimum availability.

Flexible hours

Licensed in either Florida or Ohio or both

Hourly pay rate: Range will depend on the specialty, licenses, clinical and MCO experience: $50 - $57/case for all UM, $150-$170/hour for mandatory trainings and meetings

Behavioral Health Physician (MD/DO) – Utilization Management (1099 Contractor)
Role Summary
The Behavioral Health Physician will serve as an independent contractor providing physician-level utilization management (UM) services for behavioral health services. This role is non-clinical and limited exclusively to medical necessity determinations, peer-to-peer reviews, and appeals in accordance with applicable regulations, accreditation standards, and plan policies.
Scope of Services
The Contractor will perform UM activities including, but not limited to:

Initial Medical Necessity Reviews for behavioral health services requiring physician-level determination
Concurrent Reviews for continued authorization of services
Peer-to-Peer (P2P) Reviews with treating providers
Appeals Reviews, including first- and second-level determinations, as applicable
Issuance of adverse determinations when clinically indicated, ensuring compliance with federal and state regulations, parity requirements, and plan policies
Documentation of determinations in UM systems with clear clinical rationale and supporting criteria
Participation in quality improvement processes related to UM decisions, as requested
Exclusions / Non-ScopeThis role does not include:
Direct patient care or treatment
Prescribing services
Care coordination or case management
Administrative leadership or supervisory responsibilities

Clinical Expertise & Requirementso Medical necessity criteria (e.g., MCG, InterQual, or equivalent)o Federal and state behavioral health regulationso MHPAEA requirementso NCQA and CMS standardsWork ExpectationsReporting & Oversight

MD or DO with board certification in Psychiatry (required)
Active, unrestricted medical license in applicable state(s) of review
Experience in behavioral health utilization management, preferably in managed care or health plan settings
Demonstrated knowledge of:
Strong peer-to-peer communication skills
Independent contractor (1099) status
Remote work environment
Flexible scheduling based on case volume and turnaround time requirements
Ability to meet required regulatory and contractual decision timelines
Maintain confidentiality and comply with HIPAA and data security standards
Operates independently while adhering to health plan UM policies, delegated authority parameters, and medical policy
Subject to audit, quality oversight, and performance monitoring consistent with UM regulatory requirements

Must be a Licensed M.D. or D.O.

Must be Board Certified in Psychiatry

#ALLJ

Pay: $50.00 - $170.00 per hour

Work Location: Remote

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Refine Your Search

utilization review physician jobs in remote

Medical Director-Board Certified in Psychiatry-MD or DO

Assistant Medical Director

Regional Medical Director- (Philadelphia/Baltimore)

Physician Reviewers - Multiple remote opportunites available

Medical Director Behavioral Health, Medicaid

Physician Reviewer

Board-Certified Physician for Disability Appeal Reviews

Medical Director/ Physician Reviewer

Rheumatology - Utilization Review - Remote- 1099 (contract)

Gastroenterology (MD/DO) Utilization Review - Remote - Contract (1099)

Remote Physician | Medical Director | Utilization Management

Medical Director Behavioral Health, Medicaid

Behavioral Health Medical Director

Medical Director Behavioral Health, Medicaid

Medical Director Behavioral Health, Medicaid

PAS Physician Advisor (Level of Care / Admission Status Review)

Dermatology Utilization Review - Remote - Contract (1099)

Remote - Radiologist Utilization Review - 1099 (contract)

Oncology Utilization Review - Remote - 1099 (contract)

Endocrinologist - Independent Reviewer for Disability Appeals

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