utilization review remote chiropractor

Centene is seeking a Nursing professional to perform concurrent reviews from a home-based setting, ensuring appropriate care levels and discharge planning. Requires an Iowa license (or compact) and nursing degree with 2–4 years of related experience, including acute care exposure.The role includes coordinating with Medical Affairs and educating providers...

BayCare is seeking a Physician Advisor in Utilization Review to optimize patient throughput and ensure compliant reviews. You will collaborate with Utilization Review, Case Management, and Clinical Providers to align with organizational priorities.The role reports to the Physician Advisor Medical Director and involves active review of observation to...

Full-time Description Gateway Rehab Center (GRC) is hiring a full-time Utilization Review Liaison! In this important administrative and clinical support role, you will help ensure patients receive the appropriate level of care by coordinating authorizations, conducting utilization reviews, and collaborating with clinical teams and insurance providers to...

$40/hour - Contract for 6 monthsMust reside in TX Full time remoteCandidates must be based in TX.RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan.pay rate is $40/hourThis position is responsible for performing initial, concurrent review...

Remote position, however, candidates must reside in the State of TX or State of IL   This position is a contract for about 9 months.   Pay:  $41/hour   RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan. This Position Is Responsible For...

Remote position, however, candidates must reside in the State of TX or State of IL   This position is a contract for about 9 months.   Pay:  $41/hour   RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan. This Position Is Responsible For...

iMPROve Health is seeking an RN Reviewer (Workers' Compensation Utilization Review) to serve as an independent contractor (1099) performing independent external medical reviews remotely on an ad hoc basis.  As a peer reviewer, you will apply your clinical expertise to evaluate cases, specific to your specialty, medical necessity and/or standard of care,...

The Utilization Management Clinical Pharmacist 2 (VSP/PT) at Humana Inc. is a remote role focused on medical necessity reviews and comprehensive medication reviews for pre-authorization prescriptions. You will interpret utilization data, determine appropriate actions, and support cost-effective, high-quality patient care. Responsibilities include reviewing...

Premera Blue Cross is hiring a Utilization Review Clinician to evaluate clinical requests for medical necessity and adherence to criteria and protocols. Reviews may include inpatient, concurrent, and prior authorization, with collaboration across Medical Directors and multiple teams. You will document thoroughly, meet productivity standards, and stay current...

The Utilization Management Clinical Pharmacist 2 (VSP/PT) at Humana Inc. is a remote role focused on medical necessity reviews and comprehensive medication reviews for pre-authorization prescriptions.You will interpret utilization data, determine appropriate actions, and support cost-effective, high-quality patient care. Responsibilities include reviewing...

Comagine Health in Oregon seeks a Clinical Reviewer to evaluate medical necessity and appropriateness of behavioral health services. You will review clinical documentation, perform utilization reviews, and document determinations in an electronic medical record system while supporting care coordination across children, youth, and adults. This remote,...

Remote DUR Pharmacist – Safe & Cost-Effective Medication Use | Work From Home Analyze medication use patterns, apply clinical guidelines, and collaborate with providers — all from home. This remote Drug Utilization Review Pharmacist role is ideal for pharmacists who enjoy clinical analysis and want to improve outcomes at scale.   Key Responsibilities...

Oncology Utilization Review State Medical Licenses required: Arizona, Florida, Minnesota, North Dakota, Oregon or Tennessee Flexible Independent Contractor (1099) OpportunityABOUT MRIoAFounded in 1983, Medical Review Institute of America (MRIoA) is a nationally recognized Independent Review Organization (IRO) specializing in technology-driven utilization...

UnitedHealth Group seeks a Medical Director to provide physician support for Enterprise Clinical Services. You will apply clinical knowledge to benefit coverage determinations and quality improvements while collaborating with providers and internal teams.The role offers remote work from anywhere in the U.S., with emphasis on cost-effective, high-quality care...

UnitedHealth Group seeks a Medical Director to provide physician support for Enterprise Clinical Services. You will apply clinical knowledge to benefit coverage determinations and quality improvements while collaborating with providers and internal teams.The role offers remote work from anywhere in the U.S., with emphasis on cost-effective, high-quality care...

Flexible Independent Contractor (1099) OpportunityInterventional Radiology Contract Reviews - Remote - Any State Medical License ABOUT MRIoAFounded in 1983, Medical Review Institute of America (MRIoA) is a nationally recognized Independent Review Organization (IRO) specializing in technology-driven utilization management and clinical medical review...

Flexible Independent Contractor (1099) OpportunityInterventional Radiology Contract Reviews - Remote - Any State Medical License ABOUT MRIoAFounded in 1983, Medical Review Institute of America (MRIoA) is a nationally recognized Independent Review Organization (IRO) specializing in technology-driven utilization management and clinical medical review...

DescriptionUtilization Review RN - Remote. This position is Per Diem and will work 8-hour, Day shifts.  Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA ministries. Conduct clinical reviews and review medical records daily during admission for all payers, as required by the health plans. This role requires a strong...

Remote DUR Pharmacist – Safe & Cost-Effective Medication Use | Work From Home Analyze medication use patterns, apply clinical guidelines, and collaborate with providers — all from home. This remote Drug Utilization Review Pharmacist role is ideal for pharmacists who enjoy clinical analysis and want to improve outcomes at scale.   Key Responsibilities...

This position is fully remote, however, you must reside in the State of Texas The position is a contract for about 6 months. RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan.