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Medical Review Jobs in Remote, OR (NOW HIRING)

Umpqua Health

Utilization Review Specialist

Winston, OR · On-site

$41K - $47K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Utilization Review Specialist HYBRID, must be able to travel to 3031 NE STEPHENS ST. ROSEBURG, OR ... Knowledge of medical terminology, procedure codes, and diagnosis codes * Familiarity with Oregon ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

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

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

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 Clinician

Roseburg, OR · On-site +1

$80K - $94K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Evaluate behavioral health and substance use disorder services to determine medical necessity, level of care, benefit eligibility, and compliance with established clinical guidelines. * Review ...

Umpqua Health

Utilization Review Clinician

Roseburg, OR · Remote

$80K - $94K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Evaluate behavioral health and substance use disorder services to determine medical necessity, level of care, benefit eligibility, and compliance with established clinical guidelines. * Review ...

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 ...

Greater Good Health

Medical Assistant

Roseburg, OR · On-site

$20 - $24/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Medical Assistant Location: Roseburg , OR Clinic Hours: 8a-5p (PST), Monday - Friday Company ... Oversees the laboratory and related activities including reviewing lab orders, drawing blood ...

Greater Good Health

Medical Assistant

Roseburg, OR · On-site

$20 - $24/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Medical Assistant Location: Roseburg , OR Clinic Hours: 8a-5p (PST), Monday - Friday Company ... Oversees the laboratory and related activities including reviewing lab orders, drawing blood ...

U.S. Navy

Medical Assistant

Bandon, OR

$16.75 - $21.50/hr

  • Medical

  • Dental

  • Vision

  • Retirement

Medical Assistant/Technician (Hospital Corpsman) Category / Component: Enlisted Both Overview ... will be reviewed with you by a recruiter. Additional qualifications for this job may include:

U.S. Navy

Medical Assistant

Coquille, OR

$18.75 - $24.25/hr

  • Medical

  • Dental

  • Vision

  • Retirement

Medical Assistant/Technician (Hospital Corpsman) Category / Component: Enlisted Both Overview ... will be reviewed with you by a recruiter. Additional qualifications for this job may include:

U.S. Navy

Medical Assistant

Myrtle Creek, OR

$16.50 - $21.25/hr

  • Medical

  • Dental

  • Vision

  • Retirement

Medical Assistant/Technician (Hospital Corpsman) Category / Component: Enlisted Both Overview ... will be reviewed with you by a recruiter. Additional qualifications for this job may include:

U.S. Navy

Medical Assistant

Powers, OR

$17.75 - $22.75/hr

  • Medical

  • Dental

  • Vision

  • Retirement

Medical Assistant/Technician (Hospital Corpsman) Category / Component: Enlisted Both Overview ... will be reviewed with you by a recruiter. Additional qualifications for this job may include:

U.S. Navy

Medical Assistant

North Bend, OR

$16.50 - $21/hr

  • Medical

  • Dental

  • Vision

  • Retirement

Medical Assistant/Technician (Hospital Corpsman) Category / Component: Enlisted Both Overview ... will be reviewed with you by a recruiter. Additional qualifications for this job may include:

U.S. Navy

Medical Assistant

North Bend, OR

$16.50 - $21/hr

  • Medical

  • Dental

  • Vision

  • Retirement

Medical Assistant/Technician (Hospital Corpsman) Category / Component: Enlisted Both Overview ... will be reviewed with you by a recruiter. Additional qualifications for this job may include:

U.S. Navy

Medical Assistant

North Bend, OR

$16.50 - $21/hr

  • Medical

  • Dental

  • Vision

  • Retirement

Medical Assistant/Technician (Hospital Corpsman) Category / Component: Enlisted Both Overview ... will be reviewed with you by a recruiter. Additional qualifications for this job may include:

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Showing results 1-20

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 Aug 18, 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 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.

What are the key skills and qualifications needed to thrive as a medical reviewer?

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.

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.

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.

How do you become a medical reviewer?

To become a medical reviewer, typically one needs a medical degree such as an MD or DO, along with clinical experience in a relevant specialty. Additional qualifications may include familiarity with medical guidelines, strong analytical skills, and sometimes certification in medical review or coding; some roles also require knowledge of healthcare regulations and documentation standards.

How much do medical reviewers make in the US?

Medical reviewers in the US typically earn between $60,000 and $90,000 annually, depending on experience, location, and employer. Many roles require medical credentials and familiarity with healthcare regulations, with some positions offering additional benefits or bonuses.

What are popular job titles related to Medical Review jobs in Remote, OR?

For Medical Review jobs in Remote, OR, the most frequently searched job titles are:

What job categories do people searching Medical Review jobs in Remote, OR look for?

The top searched job categories for Medical Review jobs in Remote, OR are:

Medical Review jobs near you
Infographic showing various Medical Review job openings in Remote, OR as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 14% Part Time, and 7% Contract. Highlights an 75% Physical, 1% Hybrid, and 24% Remote job distribution, with an average salary of $164,569 per year, or $79.1 per hour.

Utilization Review Specialist

Umpqua Health

Winston, OR • On-site

$41K - $47K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 27 days ago

Job description

Utilization Review Specialist
HYBRID, must be able to travel to 3031 NE STEPHENS ST. ROSEBURG, OR 97470
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 Review Specialist supports Umpqua Health Alliance by coordinating the intake, review, processing, and completion of prior authorization requests within Medical Management. This role is responsible for ensuring accurate and timely handling of authorizations, maintaining compliance with regulatory and organizational requirements, supporting communication with providers and members, and assisting with workflow coordination to promote efficient utilization management operations.
ESSENTIAL JOB RESPONSIBILITIES
  • Support Utilization Review activities related to the prior authorization process.
  • Manage intake, tracking, and routing of prior authorization requests and supporting documentation.
  • Review requests for completeness and ensure appropriate routing for processing.
  • Communicate with healthcare providers to obtain additional information and resolve documentation issues.
  • Track prior authorization requests using established systems to ensure timely processing.
  • Support timely notification of prior authorization determinations.
  • Coordinate daily workflow and telephone coverage with team members.
  • Respond to internal and external inquiries regarding prior authorizations and route as appropriate.
  • Monitor and report on turnaround times to ensure compliance with requirements.
  • Maintain knowledge of applicable regulations, policies, and procedures.
  • Comply with organizational policies and applicable to federal, state, and local regulations.
CHALLENGES
  • Strong organizational skills with the ability to stay organized and productive in a remote, independent work environment
  • Proactive communication with internal and external stakeholders
  • Consistent ability to meet Oregon Health Plan (OHA) timeline and turnaround requirements
  • Ability to manage shifting priorities in a fast-paced environment
  • Ability to coordinate tasks and resources to meet operational goals and objectives
MINIMUM QUALIFICATIONS
  • High school diploma or equivalent.
  • Proficient computer skills, including Microsoft Office Suite (Word, Excel, Outlook, Teams), data entry, and internet research.
  • Experience using standard office equipment and systems, including keyboarding, web-based phone systems, and cloud-based document storage.
  • Ability to type a minimum of 45 words per minute with a high degree of accuracy.
  • Strong attention to detail.
  • No suspension, exclusion, or debarment from participation in federal healthcare programs (e.g., Medicare/Medicaid)
PREFERRED QUALIFICATIONS
  • 1+ years of experience in healthcare, managed care, medical coding, claims processing, or a related field
  • Knowledge of medical terminology, procedure codes, and diagnosis codes
  • Familiarity with Oregon Health Plan (OHP) and Coordinated Care Organizations (CCO), including applicable regulations (OAR, ORS, CFR, CMS, DMAP)
  • Strong organizational skills with the ability to manage multiple priorities in a fast-paced environment
  • Ability to meet deadlines while maintaining accuracy and attention to detail
  • Strong communication and customer service skills (written, verbal, and interpersonal)
  • Ability to work independently and collaboratively with sound judgment and confidentiality
  • Strong critical thinking and time management skills
  • Self-motivated with ability to follow policies, procedures, and workflows in a remote environment
  • Flexible and adaptable in a changing work environment
  • Willingness to learn and take on additional responsibilities as needed
  • Ability to work a standard schedule: Monday-Friday, 8:00 AM-5:00 PM PST
  • Experience working in diverse teams and with varied communication styles
  • Experience considering the impact of work on diverse communities, including communities of color
  • Bilingual or translation skills preferred

SCHEDULE
Monday through Friday - 8:00am - 5:00pm; standard business hours with flexibility to meet service timelines.
SALARY
Wage Band : $41,600- $47,000
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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