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Medical Review Jobs in Remote, OR (NOW HIRING)

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

Escalate complex cases to Medical Directors and request additional documentation as needed ... review or case management experience in managed care * Oregon residency and license * Bilingual or ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · Remote

$85K - $105K/yr

Escalate complex cases to Medical Directors and request additional documentation as needed ... review or case management experience in managed care * Oregon residency and license * Bilingual or ...

Aviva Health

Designated Medical Provider

Roseburg, OR · On-site

Participate in MDT staffing, case reviews, and coordinated care planning. Communicate clearly and ... Designated Medical Provider v1.2026 2 of 3 Travel using personal or company vehicle. Quality ...

Aviva Health

Designated Medical Provider

Roseburg, OR · On-site

Medical-Forensic Care * Perform pediatric sexual assault medical-forensic examinations (P-SANE ... Participate in MDT staffing, case reviews, and coordinated care planning. * Communicate clearly and ...

Aviva Health

Designated Medical Provider

Roseburg, OR · On-site

... MDT staffing, case reviews, and coordinated care planning. • Communicate clearly and ... Designated Medical Provider v1.2026 2 of 3 • Travel using personal or company vehicle. Quality ...

Vensure Employer Services

Be Seen First

Medical Assistant

OR · Remote

$18.25 - $23.25/hr

What You'll Do As a Remote Medical Assistant, you'll play an essential role in supporting our ... Review laboratory results and route information to providers as appropriate * Follow up with ...

Aviva Health

Lead Certified Medical Assistant

Roseburg, OR

$16.25 - $21.25/hr

Maintain and review training and orientation check-off lists on new medical assistants. * Assist supervisors in the development of MA training program and orientation checklist and provide training ...

Aviva Health

Lead Certified Medical Assistant

Roseburg, OR · On-site

$23.81 - $29.10/hr

Maintain and review training and orientation check-off lists on new medical assistants. * Assist supervisors in the development of MA training program and orientation checklist and provide training ...

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All JobsMedical Review JobsMedical Review Jobs in Remote, OR

Medical Review information

See Remote, OR salary details

$36.5K

$164.6K

$336.7K

How much do medical review jobs pay per year?

As of Jul 28, 2026, the average yearly pay for medical review in Remote, OR is $164,569.00, according to ZipRecruiter salary data. Most workers in this role earn between $63,900.00 and $268,200.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Medical Reviewer, and why are they important?

To thrive as a Medical Reviewer, you need a strong understanding of clinical medicine, scientific research, and regulatory guidelines, often supported by a medical degree or advanced healthcare qualification. Familiarity with medical databases, regulatory submission systems, and tools like MedDRA coding or CTD formatting is typically required. Attention to detail, analytical thinking, and effective written communication are essential soft skills for reviewing complex documents and collaborating with multidisciplinary teams. These skills ensure accurate, compliant, and high-quality medical evaluations that support regulatory approvals and patient safety.

What is medical review?

Medical review refers to the process of evaluating medical information, records, or claims to ensure accuracy, compliance, and appropriateness based on clinical guidelines and policies. Professionals in medical review often assess documentation for insurance claims, pre-authorization requests, or clinical trials. Their work helps ensure that patients receive appropriate care and that healthcare providers follow industry standards.

How does a Medical Review professional typically collaborate with other departments within a healthcare or insurance organization?

Medical Review professionals frequently work closely with clinical staff, claims adjusters, and compliance teams to ensure that medical records and claims are accurately assessed and meet regulatory standards. Collaboration often involves discussing complex cases, clarifying clinical documentation, and providing guidance on policy interpretation. Effective communication and teamwork are essential, as Medical Review staff often act as a bridge between medical and administrative teams to support fair and thorough claims processing.

How to become a medical reviewer?

To become a medical reviewer, typically a healthcare professional such as a physician, nurse, or pharmacist with relevant clinical experience is required. Candidates often need a medical license, strong knowledge of medical guidelines, and familiarity with medical documentation and review processes. Additional certifications or training in medical coding, compliance, or insurance review can enhance qualifications.

What is the role of a medical reviewer?

A medical reviewer evaluates medical records, claims, and documentation to ensure accuracy, compliance, and appropriate treatment. They often work in insurance, healthcare, or regulatory settings, requiring clinical knowledge and attention to detail to make informed decisions about patient care or claims processing.

What jobs make $3,000 a month without a degree?

Medical review roles, such as medical coders or billers, can pay around $3,000 monthly without requiring a degree, often needing certification and familiarity with healthcare software. Other non-degree jobs that may reach this income level include sales representatives, certain skilled trades, or administrative roles with experience, but these typically require specific skills or certifications. Income varies based on location, experience, and industry demand.

What is the difference between Medical Review vs Medical Coding Specialist?

AspectMedical ReviewMedical Coding Specialist
Required CredentialsMedical degree or clinical background, certifications like CCM or CRCCertification in coding (CPC, CCS), knowledge of coding systems
Work EnvironmentHealthcare facilities, insurance companies, telehealthHospitals, clinics, insurance companies, remote coding
Employer & Industry UsageUsed to assess medical necessity, compliance, and documentationUsed to assign billing codes based on medical records

Medical Review involves evaluating medical records for accuracy, compliance, and appropriateness, often requiring clinical expertise. Medical Coding Specialists focus on translating medical documentation into standardized codes for billing and insurance purposes. While both roles require healthcare knowledge, Medical Review emphasizes clinical assessment, whereas Medical Coding centers on coding accuracy for reimbursement.

What is the 3 month rule for jobs?

In the context of medical review jobs, the 3 month rule often refers to a probationary period during which an employee's performance is closely monitored before full employment benefits or permanent status are granted. This period allows employers to assess the employee's skills, reliability, and fit for the role, which may include tasks like reviewing medical records or ensuring compliance with healthcare regulations.
Medical Review jobs near you
Infographic showing various Medical Review job openings in Remote, OR as of July 2026, with employment types broken down into 1% As Needed, 78% Full Time, 14% Part Time, and 7% Contract. Highlights an 88% Physical, 1% Hybrid, and 11% Remote job distribution, with an average salary of $164,569 per year, or $79.1 per hour.
Utilization Review Nurse

Utilization Review Nurse

Umpqua Health

Roseburg, OR • On-site, Remote

$85K - $105K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 26 days ago

Job description

UTILIZATION REVIEW NURSE
REMOTE
Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 97457, as needed for business operations.
EMPLOYMENT TYPE: Full-Time, Exempt
About Umpqua Health
At Umpqua Health, we're more than a healthcare organization-we're a community-driven Coordinated Care Organization (CCO) dedicated to improving the health and well-being of individuals and families throughout Douglas County, Oregon. We provide integrated, whole-person care through primary care, specialty care, behavioral health services, and care coordination. Our collaborative approach ensures members receive high-quality, personalized care while supporting a stronger, healthier community.
POSITION PURPOSE
The Utilization Management Nurse evaluates clinical service requests to ensure medically necessary, cost-effective, and evidence-based care for members. This role conducts prior authorizations, facilitates care coordination, and supports safe transitions across care settings, ensuring compliance with Oregon Health Plan (OHP), Medicare, and applicable regulations. The UM Nurse collaborates with interdisciplinary teams and community providers to promote integrated, high-quality care.
ESSENTIAL JOB RESPONSIBILITIES
  • Perform clinical assessments and prior authorizations to determine medical necessity
  • Escalate complex cases to Medical Directors and request additional documentation as needed
  • Collaborate with care coordinators, discharge planners, and interdisciplinary teams for care transitions
  • Liaise with internal departments to resolve eligibility, benefits, or service issues
  • Participate in discharge planning for members transitioning from acute, long-term, or residential care
  • Conduct audits and support quality improvement initiatives
  • Provide training and mentorship on UM protocols and workflows
  • Maintain relationships with community providers and service organizations
  • Ensure compliance with organizational policies, clinical standards, and federal/state regulations
  • Perform other nursing-related duties as assigned

CHALLENGES
  • Working with a variety of personalities, maintaining a consistent and fair communication style.
  • Satisfying the needs of a fast-paced and challenging company.

MINIMUM QUALIFICATIONS
  • Active, unrestricted RN license (BSN or MSN) in Oregon or a compact state
  • Graduation from an accredited nursing program
  • Minimum 5 years of direct patient care experience
  • Proficiency with Microsoft Office, EHR systems, and UM software
  • Strong clinical knowledge, communication, and organizational skills
  • No suspension, exclusion, or debarment from federal healthcare programs

PREFERRED QUALIFICATIONS
  • 2+ years of utilization review or case management experience in managed care
  • Oregon residency and license
  • Bilingual or translation skills a plus
  • Experience with quality improvement audits and diverse team collaboration
  • Ability to work independently in fast-paced environments
SCHEDULE
Monday through Friday - 8:00am - 5:00pm; standard business hours with flexibility to meet service timelines.
SALARY
Wage Band: $85,000- $105,340
BENEFITS
  • Salary is dependent on skills, experience, and education
  • Generous benefits package including vacation PTO, sick leave, federal holidays, and birthday leave
  • Medical, dental, and vision insurance
  • 401(k) with company match (fully vested immediately)
  • Company-sponsored life insurance and additional benefits
  • Fitness reimbursement program
  • Tuition reimbursement and more

Why Umpqua Health?
We are committed to advancing health equity by collaborating across communities, addressing systemic barriers, and ensuring fair access to care and resources. At Umpqua Health, every team member plays a vital role in making a meaningful impact, empowering healthier lives and strengthening the communities we serve.
Inclusive Culture
We foster a respectful, inclusive environment where employees feel valued, supported, and empowered.
Growth & Development
We support ongoing learning through mentorship, clear career pathways, and professional development opportunities.
Work/Life Balance
We promote flexibility and well-being so employees can thrive both professionally and personally.
Equal Opportunity
Umpqua Health is an equal opportunity employer that embraces individuals from all backgrounds. We prohibit discrimination and harassment of any kind, ensuring that all employment decisions are based on qualifications, merit, and the needs of the business. Our dedication to fairness and equality extends to all aspects of employment, including hiring, training, promotion, and compensation, without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, veteran status, or any other protected category under federal, state, or local law.

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