Top 4757 physician consultant remote Jobs

Utilization Management Physician Reviewer
Toney HealthCare Consulting, LLC —Remote
- From $175 an hour
- Part-time
- Remote
- Medicine
- 3 years
- Senior level
- Health insurance
Quick Apply
Sales Representative – Skin Grafts & Allografts (Commission-Only)
DERMALYNX INC —Remote
- $8,000 - $20,000 a month
- Part-time
- Remote
- Clinic
- Travel
- 1 year
Quick Apply
Multi-Licensed Nurse Practitioner - Weight Loss - Telemedicine
Hims & Hers Health, Inc. —Remote
- $10 - $170 an hour
- Contract
- Remote
- Nursing
- Customer service
- Mid-level
- Flexible schedule
Pulmonary Telehealth Nurse Practitioner - Florida License
Inspire Health Alliance —Remote
- From $55 an hour
- Choose your own hours
- Remote
- Nursing
- Anatomy knowledge
- Skilled nursing facility
- Flexible schedule
Quick Apply
Gastroenterology Telehealth Nurse Practitioner - Florida Licensed
Inspire Health Alliance —Remote
- From $55 an hour
- Choose your own hours
- Remote
- Nursing
- Skilled nursing facility
- BC/BE
- Flexible schedule
Quick Apply
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
Oversight BC Occ Health Physician - NY
InHouse Physicians —New York State
- $3,000 - $5,000 a year
- Email
- Remote
- Background check
- Mid-level
- 3 years
Quick Apply
Medical Director (MD/DO) – Florida | Dermatologist or Plastic Surgeon Job Type: Contract (1099)
Confidential —Florida
- $1,000 - $10,000 a month
- Contract
- Remote
- Medicine
- Surgery
- Supervising experience
- Health insurance
Quick Apply
3d
Aesthetic Nurse Practitioner
Pinch Med Spa —Cleveland, OH
- $25,000 - $200,000 a year
- Choose your own hours
- Remote
- Nursing
- Mid-level
- Patient care
- Flexible schedule
Quick Apply
5d
Bilingual Advanced Practice Provider (English/Mandarin)
Elevance Health —Albany, NY
- $115,184 - $198,144 a year
- Full-time
- Remote
- Nursing
- RN License
- Certified Nurse Practitioner
- Employee stock purchase plan
- Paid holidays
Medical Director- Pulmonologist
South Eastern Medical Consulting —Florida
- $150,000 - $200,000 a year
- Contract
- Remote
- Management
- BC/BE
- Organizational skills
Quick Apply
South Carolina Based Collaborating Physicians and Medical Directors (board certified US physicians)
Doctors For Providers —South Carolina
- $2,400 - $10,000 a year
- Contract
- Remote
- Background check
- BC/BE
- Senior level
- Flexible schedule
Quick Apply
Collaborative/Supervising Physician — Part Time/Flexible
Solara Health Group —Remote
- $3,500 - $4,500 a month
- Part-time
- Remote
- Medicine
- Psychiatry
- Addiction Medicine
- Flexible schedule
Quick Apply
Clinical Psychologist
Harbor Psychiatry & Mental Health —Remote
- $141,400 - $163,620 a year
- Full-time
- Remote
- Doctoral degree
- Psychiatry
- Addiction Medicine
- Health savings account
- Health insurance
Quick Apply
Physician Reviewer (Hematology / Oncology / ENT / Orthopedics / Radiology)
TMF Health Quality Institute —Remote
- $10 - $150 an hour
- Contract
- Remote
- Medicine
- BC/BE
- Senior level
Quick Apply
Assistant Medical Director
Medical Mutual of Ohio —Ohio
- Remote
- Medicine
- 5 years
- Word processing
- Health savings account
- Disability insurance
MD/DO - Remote Collaborating Physician - Telehealth / Psychiatrist (50-state licensed)
Songbird Therapy —Remote
- Up to $100,000 a year
- Contract
- Remote
- Medicine
- Psychiatry
- US work authorization
- Flexible schedule
Quick Apply
Physician Reviewer (Part Time)
CareCentrix —Remote
- $150 - $170 an hour
- Part-time
- Remote
- Medicine
- BC/BE
- 3 years
6d
Physician Assistant for In-home Visits
Signify Health —Bethany, OK
- $1,800 - $3,000 a week
- No weekends
- Remote
- Mid-level
- Home Health
- Home health
- Flexible schedule
Quick Apply
Clinical Policy Advisor
Massachusetts Health Connector —Massachusetts
- $85 - $95 an hour
- Part-time
- Remote
- Nursing
- Medicine
- Microsoft Office
- Health insurance
Quick Apply
9d

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Utilization Management Physician Reviewer

Toney HealthCare Consulting, LLC -
Remote

Quick Apply

Job Details

Part-time | Contract
From $175 an hour

Benefits

Health insurance

Qualifications

Electronic health records (EHR) management
Utilization management
Resource utilization in healthcare
Medical License

Full Job Description

Job Overview

The Physician Reviewer serves as a clinical subject matter expert in the Utilization Management (UM) department. This role is responsible for conducting clinical reviews of medical necessity, appropriateness of care, and service requests based on evidence-based guidelines, medical policy, and regulatory requirements. The Physician Reviewer collaborates with UM nurses, medical directors, and other healthcare professionals to ensure appropriate, timely, and cost-effective care for members.

Key Responsibilities:

Conduct physician-level reviews of prior authorization, concurrent review, and retrospective review cases across multiple lines of business (e.g., commercial, Medicaid, Medicare).
Apply nationally recognized clinical criteria (e.g., MCG, InterQual), internal medical policies, and applicable regulations (CMS, NCQA, URAC) to review determinations.
Render clinical decisions in a timely manner consistent with regulatory timeframes and health plan policies.
Collaborate with medical directors, case managers, and care teams to support optimal care pathways.
Participate in audits, appeals, and grievance processes as needed.
Maintain current knowledge of clinical best practices, industry trends, and regulatory changes.
Participate in peer-to-peer discussions with attending physicians to communicate UM decisions and promote evidence-based care.
Analyze clinical data and documentation to support accurate determinations and appeals.
Contribute to the development and refinement of clinical policies and UM protocols specific to specialized care.
Provide guidance on clinical appropriateness, benefit coverage, and policy interpretation.
Provide education and clinical support to internal teams and external providers regarding best practices and clinical pathways.
Ensure compliance with regulatory, accreditation, and legal requirements in all UM activities.
Ensure adherence to all HIPAA, confidentiality, and privacy standards.
Participate in quality improvement initiatives and clinical case rounds.

Qualifications:

Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree required.
Active and unrestricted medical license.
Minimum of 5 years of clinical practice experience in the respective specialty.
At least 3 years of experience in utilization management within a health plan.
Familiarity with evidence-based guidelines and UM tools (e.g., InterQual, MCG).
Strong communication and documentation skills.
Proficiency with electronic medical records and clinical review platforms.
Experience with Medicare/Medicaid and commercial insurance regulations is preferred.

Preferred Skills:

Experience with Medicare and/or Medicaid managed care plans.
Knowledge of medical necessity appeal processes and peer review protocols.
Knowledge of CMS, NCQA, and/or URAC standards.
Previous peer review or medical director experience.
Comfortable working in a remote, collaborative environment.

Pay: From $175.00 per hour

Experience:

Utilization Management Review: 3 years (Required)
Medicare and/or Medicaid: 2 years (Preferred)

License/Certification:

Board-certified M.D. or D.O. medical license? (Required)

Work Location: Remote

Quick Apply

Refine Your Search

physician consultant remote jobs

Utilization Management Physician Reviewer

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Medical Director-Board Certified in Psychiatry-MD or DO

Oversight BC Occ Health Physician - NY

Medical Director (MD/DO) – Florida | Dermatologist or Plastic Surgeon Job Type: Contract (1099)

Aesthetic Nurse Practitioner

Bilingual Advanced Practice Provider (English/Mandarin)

Medical Director- Pulmonologist

South Carolina Based Collaborating Physicians and Medical Directors (board certified US physicians)

Collaborative/Supervising Physician — Part Time/Flexible

Clinical Psychologist

Physician Reviewer (Hematology / Oncology / ENT / Orthopedics / Radiology)

Assistant Medical Director

MD/DO - Remote Collaborating Physician - Telehealth / Psychiatrist (50-state licensed)

Physician Reviewer (Part Time)

Physician Assistant for In-home Visits

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