Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...
Quick apply
Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...
Quick apply
Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...
Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...
Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...
Atlanta, GA · On-site
$114K - $136K/yr
This role supports key clinical pharmacy programs, including Drug Utilization Review (DUR), Drug ... contracts) based on medical necessity criteria, and coordinates with internal stakeholders or ...
Atlanta, GA · On-site
$114K - $136K/yr
This role supports key clinical pharmacy programs, including Drug Utilization Review (DUR), Drug ... contracts) based on medical necessity criteria, and coordinates with internal stakeholders or ...
Atlanta, GA · On-site
$114K - $136K/yr
This role supports key clinical pharmacy programs, including Drug Utilization Review (DUR), Drug ... contracts) based on medical necessity criteria, and coordinates with internal stakeholders or ...
Atlanta, GA · On-site
$114K - $136K/yr
This role supports key clinical pharmacy programs, including Drug Utilization Review (DUR), Drug ... contracts) based on medical necessity criteria, and coordinates with internal stakeholders or ...
Atlanta, GA · On-site
$114K - $136K/yr
This role supports key clinical pharmacy programs, including Drug Utilization Review (DUR), Drug ... contracts) based on medical necessity criteria, and coordinates with internal stakeholders or ...
Atlanta, GA · On-site
$114K - $136K/yr
This role supports key clinical pharmacy programs, including Drug Utilization Review (DUR), Drug ... contracts) based on medical necessity criteria, and coordinates with internal stakeholders or ...
The Manager of Contract Administration and Analysis will provide support to the Contract Managers ... Work with clinical specialty committees to review utilization and product standardization GPO ...
The Manager of Contract Administration and Analysis will provide support to the Contract Managers ... Work with clinical specialty committees to review utilization and product standardization GPO ...
The Manager of Contract Administration and Analysis will provide support to the Contract Managers ... Work with clinical specialty committees to review utilization and product standardization GPO ...
The Manager of Contract Administration and Analysis will provide support to the Contract Managers ... Work with clinical specialty committees to review utilization and product standardization GPO ...
$41.28 - $50.30/hr
Work with clinical specialty committees to review utilization and product standardization GPO ... Coordinate with contract managers and end users to address supply disruptions and recalls ...
$41.28 - $50.30/hr
Work with clinical specialty committees to review utilization and product standardization GPO ... Coordinate with contract managers and end users to address supply disruptions and recalls ...
Atlanta, GA · On-site
$1.8K/wk
... Utilization Review Nurse - Clinical Schedule Monday-Friday Requirements - RN licensure: GA or ... hours of contract signing. - All compliance documents due the Tuesday prior to start. - If not ...
Atlanta, GA · On-site
$1.8K/wk
... Utilization Review Nurse - Clinical Schedule Monday-Friday Requirements - RN licensure: GA or ... hours of contract signing. - All compliance documents due the Tuesday prior to start. - If not ...
The Manager of Contract Administration and Analysis will provide support to the Contract Managers ... Work with clinical specialty committees to review utilization and product standardization GPO ...
The Manager of Contract Administration and Analysis will provide support to the Contract Managers ... Work with clinical specialty committees to review utilization and product standardization GPO ...
... contract. * May process a medical necessity denial determination made by a Medical Director ... Requires a minimum of 6 years of clinical experience and/or utilization review experience.
... contract. * May process a medical necessity denial determination made by a Medical Director ... Requires a minimum of 6 years of clinical experience and/or utilization review experience.
Atlanta, GA · On-site
$64K - $81K/yr
... contract. * May process a medical necessity denial determination made by a Medical Director ... Requires a minimum of 6 years of clinical experience and/or utilization review experience.
Atlanta, GA · On-site
$64K - $81K/yr
... contract. * May process a medical necessity denial determination made by a Medical Director ... Requires a minimum of 6 years of clinical experience and/or utilization review experience.
$64K - $81K/yr
... contract. * May process a medical necessity denial determination made by a Medical Director ... Requires a minimum of 6 years of clinical experience and/or utilization review experience.
$64K - $81K/yr
... contract. * May process a medical necessity denial determination made by a Medical Director ... Requires a minimum of 6 years of clinical experience and/or utilization review experience.
Atlanta, GA · On-site
$36K - $41K/yr
... review. How you will make an impact: * Managing incoming calls or incoming post services claims ... Determines contract and benefit eligibility; provides authorization for inpatient admission ...
Atlanta, GA · On-site
$36K - $41K/yr
... review. How you will make an impact: * Managing incoming calls or incoming post services claims ... Determines contract and benefit eligibility; provides authorization for inpatient admission ...
Atlanta, GA · On-site
Utilization Review experience is preferred. * Knowledge of the medical management processes and the ability to interpret and apply member contracts, member benefits, and managed care products is ...
Atlanta, GA · On-site
Utilization Review experience is preferred. * Knowledge of the medical management processes and the ability to interpret and apply member contracts, member benefits, and managed care products is ...
Atlanta, GA · On-site
Utilization Review experience is preferred. * Knowledge of the medical management processes and the ability to interpret and apply member contracts, member benefits, and managed care products is ...
Atlanta, GA · On-site
Utilization Review experience is preferred. * Knowledge of the medical management processes and the ability to interpret and apply member contracts, member benefits, and managed care products is ...
Atlanta, GA · On-site
$2.0K/wk
Travel/Contract Opportunity Shift: Days | 8-Hour Shifts Requirements: • Minimum 3 years of Case ... of utilization review and discharge planning processes • Comfortable working in a fast-paced ...
Atlanta, GA · On-site
$2.0K/wk
Travel/Contract Opportunity Shift: Days | 8-Hour Shifts Requirements: • Minimum 3 years of Case ... of utilization review and discharge planning processes • Comfortable working in a fast-paced ...
... review. How you will make an impact: * Managing incoming calls or incoming post services claims ... Determines contract and benefit eligibility; provides authorization for inpatient admission ...
New
... review. How you will make an impact: * Managing incoming calls or incoming post services claims ... Determines contract and benefit eligibility; provides authorization for inpatient admission ...
New
Atlanta, GA · On-site
$2.0K/wk
Utilization Review * Length of Stay Management * Resource Coordination * Patient Advocacy ... contracts to our workforce. Our experienced team takes the time to get to know both our clients and ...
Atlanta, GA · On-site
$2.0K/wk
Utilization Review * Length of Stay Management * Resource Coordination * Patient Advocacy ... contracts to our workforce. Our experienced team takes the time to get to know both our clients and ...
Decatur, GA · Remote
... utilization review, or managed care experience; or any combination of education and experience ... Job Type: Contract Additional Details: * Work Schedule: (Monday-Friday) 8:00am-5:00pm (EST)
Decatur, GA · Remote
... utilization review, or managed care experience; or any combination of education and experience ... Job Type: Contract Additional Details: * Work Schedule: (Monday-Friday) 8:00am-5:00pm (EST)
$20.89 - $25.11
2% of jobs
$25.11 - $29.34
9% of jobs
$32.23 is the 25th percentile. Wages below this are outliers.
$29.34 - $33.56
21% of jobs
The median wage is $36.98 / hr.
$33.56 - $37.79
23% of jobs
$37.79 - $42.01
13% of jobs
$45.30 is the 75th percentile. Wages above this are outliers.
$42.01 - $46.24
10% of jobs
$46.24 - $50.46
8% of jobs
$50.46 - $54.68
5% of jobs
$54.68 - $58.91
5% of jobs
$58.91 - $63.13
2% of jobs
$63.13 - $67.36
2% of jobs
$20
$41
$67
To thrive in Contract Utilization Review, you need a solid understanding of medical terminology, insurance policies, and contract compliance, often supported by a healthcare-related degree or certification in utilization management. Familiarity with utilization review software, electronic medical records (EMR), and knowledge of regulatory standards such as CMS guidelines is essential. Strong analytical thinking, attention to detail, and effective communication skills are crucial for collaborating with care teams and insurers. These abilities ensure reviews are accurate, contracts are properly administered, and patient care meets organizational and payer requirements.
A typical day in Contract Utilization Review involves reviewing patient medical records, ensuring adherence to payer contracts and regulatory standards, and communicating with healthcare providers to validate medical necessity of services. Professionals in this role often collaborate with clinical staff, case managers, and insurance representatives to resolve discrepancies or authorization issues. The work is detail-oriented and deadline-driven, making organizational skills vital. This dynamic position offers significant opportunities to learn more about healthcare regulations and may serve as a stepping stone toward more advanced roles in healthcare administration or compliance.
A Contract Utilization Review job involves analyzing and evaluating the usage of contracts to ensure compliance, cost-effectiveness, and efficiency. Professionals in this role review contract terms, monitor vendor performance, and assess utilization data to optimize contract value. They may work in industries such as healthcare, government, or procurement, ensuring that agreements are being properly executed. The goal is to identify areas for improvement, reduce waste, and enhance operational efficiency.

Full-time
Re-posted 27 days ago
Dane Street is expanding our physician panel! We are seeking a skilled and board-certified Orthopedic Surgeon in East Point, GA to join our team for Independent Medical Examinations (IMEs). This role offers flexible scheduling, allowing you to select or decline assignments based on your availability. Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case basis.
Dane Street is a national leader in Independent Medical Examinations (IMEs) and peer review services, trusted by insurance carriers and organizations across the country for objective, high-quality medical evaluations.
Key Responsibilities:
Requirements
Benefits
If you are a dedicated Orthopedic Surgeon looking for a flexible opportunity to apply your expertise in an IME capacity, we encourage you to apply.
Sourced by ZipRecruiter
51 - 200 Employees
Boston, MA, US
2008