ZipRecruiter

Log In

1

Case Reviewer Jobs (NOW HIRING)

Community Health Network

Medical Reviewer

Under the general direction of the Vice President of Clinical Affairs, performs medical case review of services subject to approval under the Connecticut Medical Assistance Program (CMAP)

ICBD

Case Review Analyst

Lauderdale Lakes, FL · On-site

Case Review Analyst - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site Who We Are Exact Billing Solutions is a unique team of revenue cycle management professionals specializing in the ...

ICBD

Case Review Analyst

Lauderdale Lakes, FL

Case Review Analyst - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site Who We Are Exact Billing Solutions is a unique team of revenue cycle management professionals specializing in the ...

ICBD

Case Review Analyst

Fort Lauderdale, FL · On-site

Case Review Analyst - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site Who We Are Exact Billing Solutions is a unique team of revenue cycle management professionals specializing in the ...

OncoHealth

Case Review Specialist

About the Role The Case Review Specialist ensures that case documentation is provided by the provider for accurate and timely determinations and communicates with clinical and non-clinical staff to ...

State of Colorado

Administrative Reviewer

Denver, CO · On-site +1

$6.0K - $9.6K/mo

The federally required child welfare Case Review and Qualitative Case Review systems, Administrative Reviews Court ordered substituting Administrative Reviews Screen Out Reviews Assessment Reviews In ...

State of Colorado

Administrative Reviewer

Denver, CO · On-site +1

$6.0K - $9.6K/mo

The federally required child welfare Case Review and Qualitative Case Review systems, Administrative Reviews Court ordered substituting Administrative Reviews Screen Out Reviews Assessment Reviews In ...

State of Colorado

Administrative Reviewer

Denver, CO · On-site

$6.0K - $9.6K/mo

In-home Services Case Reviews * Institutional Abuse/Neglect Reviews * Colorado's statutorily mandated Child Fatality Review Team * Foster Home Certification Reviews * Child Welfare Hotline Reviews

State of Colorado

Administrative Reviewer

Denver, CO · On-site

$6.0K - $9.6K/mo

In-home Services Case Reviews * Institutional Abuse/Neglect Reviews * Colorado's statutorily mandated Child Fatality Review Team * Foster Home Certification Reviews * Child Welfare Hotline Reviews

New

GDIT

WV · On-site

$18 - $23.25/hr

Develop initial case review plans, including timeframes, required data, and identification of involved stakeholders. * Escalate cases when appropriate, including coordinating external reviews with ...

OncoHealth

Case Review Specialist - Atlanta

Atlanta, GA · On-site +1

About the Role The Case Review Specialist ensures that case documentation is provided by the provider for accurate and timely determinations and communicates with clinical and non-clinical staff to ...

next page

Showing results 1-20

All JobsCase Reviewer Jobs

Case Reviewer information

See salary details

$19

$47

$80

How much do case reviewer jobs pay per hour?

As of Jun 30, 2026, the average hourly pay for case reviewer in the United States is $47.53, according to ZipRecruiter salary data. Most workers in this role earn between $35.34 and $57.45 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Case Reviewer position, and why are they important?

To thrive as a Case Reviewer, you need strong analytical abilities, attention to detail, and a background in the relevant industry, often supported by a degree in law, healthcare, or a specialized field. Familiarity with case management software, electronic records systems, or regulatory databases is usually important, and certifications may be required for specialized roles. Excellent written communication, impartiality, and time management are soft skills that set top performers apart. Mastery of these skills ensures accurate, timely case evaluations and effective collaboration with stakeholders for informed decision-making.

What is a Case Reviewer job?

A Case Reviewer is responsible for evaluating case files, documents, and related information to ensure accuracy, compliance, and completeness. They analyze evidence, verify facts, and provide detailed assessments based on established guidelines or legal standards. Case Reviewers often work in legal, medical, insurance, or government sectors and must have strong attention to detail and analytical skills. Their role helps ensure fair and accurate decision-making in various professional settings.

What are the typical daily responsibilities of a Case Reviewer?

As a Case Reviewer, your day-to-day work commonly involves reviewing case files, supporting documents, and related evidence to assess compliance with relevant guidelines or policies. You may be required to write detailed reports, summarize findings, and make recommendations based on established criteria. Collaboration is frequent, as you often interact with other reviewers, supervisors, and subject matter experts to discuss complex cases or clarify information. This role demands a high level of organization and consistency, as accuracy and fairness are critical when determining outcomes that impact clients, patients, or other stakeholders.

More about Case Reviewer jobs
What cities are hiring for Case Reviewer jobs? Cities with the most Case Reviewer job openings:
What are the most commonly searched types of Case Reviewer jobs? The most popular types of Case Reviewer jobs are:
What states have the most Case Reviewer jobs? States with the most job openings for Case Reviewer jobs include:
What job categories do people searching Case Reviewer jobs look for? The top searched job categories for Case Reviewer jobs are:
What are popular job titles related to Case Reviewer jobs? For Case Reviewer jobs, the most frequently searched job titles are:
Case Reviewer jobs near you
Medical Reviewer

Medical Reviewer

Community Health Network of Connecticut, Inc.

Wallingford, CT • On-site

$174K - $249K/yr

Full-time

Medical, Dental, Vision, Life, Retirement

This job post has expired today. Applications are no longer accepted.

Key responsibilities

  • Performs medical case review of services subject to approval under the Connecticut Medical Assistance Program (CMAP).

  • Participates and contributes in medical matters related to utilization management, case management, peer review, and quality improvement processes.

  • Responds to inquiries from providers, internal stakeholders, and the Department of Social Services as necessary.

Job description

Community Health Network of Connecticut, Inc. (CHNCT) is currently seeking a Medical Reviewer.

Primary Responsibilities:

  • Under the general direction of the Vice President of Clinical Affairs, performs medical case review of services subject to approval under the Connecticut Medical Assistance Program (CMAP).
  • Participates and contributes actively in medical matters related to utilization management, case management, peer review, quality improvement and other processes requiring medical/clinical leadership and consultation.
  • Responds to inquiries from providers, internal stakeholders, and Department of Social Services as necessary.
  • Serves as a resource to CHNCT clinical staff.
  • Provides recommendations for improving care delivery and health outcomes for CMAP enrollees.
  • Participates in activities specific to contractual requirements such as Fair Hearings, etc.

Tasks Performed:

  • Appropriately documents case review findings, actions, and outcomes in keeping with established policies.
  • Collaborates with clinical staff to implement clinical and quality management programs and initiatives.
  • Interacts with providers and vendors regarding clinical care and services for CMAP enrollees.
  • Actively participates and contributes in medical review team meetings; participates in design and development of care programs and quality improvement initiatives as requested.

Essential Functions:

  • Engages in telephonic case review and discussion with providers.
  • Proactively shares resources, information and guidelines related to quality, cost-effective health care delivery.
  • Shares best practices with other Medical Reviewers, CHNCT clinical staff.
  • Applies performance data to guide interactions and inform discussions with stakeholders.
  • Maintains a high level of productivity; adheres to ASO contract standards regarding timeliness of reviews and appeals.
  • Consistently meets plan inter­rater reliability guidelines.
  • Required to attend Medical Reviewer Staff Meetings via phone or in person unless vacation, illness or other extenuating circumstances that prevents the Medical Reviewer to attend these meetings.
  • Required to be available for all training/retraining sessions via phone or in person unless vacation, illness or other extenuating circumstances that prevents the Medical Reviewer to attend these meetings. Note: training and retraining sessions may vary from year to year depending on assessment and need.
  • Required to attend all mandatory training provided by DSS.
  • Must comply with completing all company required trainings.

Desired Education: Medical School

Desired Degree: Medical Doctor or Doctor of Osteopathy

Desired Major: Primary care specialty

Desired Job Experience: Minimum 2 years as a Medical Reviewer or physician consultant in a managed care company preferred. Experience in Utilization Management, Case and Disease Management, preferably with Medicaid populations. Clinical experience in managing a range o1 pathologies and populations and up-to-date knowledge of evidence-based medical guidelines and accepted standards of care for managing the treatments, procedures, conditions, and diseases under review by CHNCT.

Other Qualifications: M.D. or D.O. current, non-restricted Connecticut license and Board certification. Flexible and able to adapt to altered work processes, technologies, and directives.

Certifications Required: Physician; Surgeon

CHNCT Offers Great Benefits:

  • Medical, dental and vision coverage options
  • Flexible spending and health savings accounts
  • Group term life insurance
  • A 401(k) plan with company-match and immediate vesting
  • Voluntary accidental injury coverage
  • Tuition reimbursement and continuing education opportunities
  • A generous paid-leave bank and company holidays
  • Wellness program

We are dedicated to having a workplace where everyone feels valued, respected, and empowered to succeed. We embrace a wide range of perspectives and backgrounds, ensuring fair treatment and opportunities for all employees. We value our team’s rich array of experiences and viewpoints, which contribute to our innovative and collaborative environment.

We are committed to providing an inclusive and accessible interview process. If you require a reasonable accommodation for your interview due to a disability. Please contact us in advance if you need an accommodation.