Utilization Review Physician
Carteret, NJ · On-site
The Utilization Review Physician is the lead clinician for the health plan ... Responsible for the administration of medical services for company health plan utilizing the ...
Carteret, NJ · On-site
The Utilization Review Physician is the lead clinician for the health plan ... Responsible for the administration of medical services for company health plan utilizing the ...
Carteret, NJ · On-site
The Utilization Review Physician is the lead clinician for the health plan ... Responsible for the administration of medical services for company health plan utilizing the ...
The Utilization Review Physician is the lead clinician for the health plan ... Responsible for the administration of medical services for company health plan utilizing the ...
The Utilization Review Physician is the lead clinician for the health plan ... Responsible for the administration of medical services for company health plan utilizing the ...
The Utilization Review Physician is the lead clinician for the health plan ... Responsible for the administration of medical services for company health plan utilizing the ...
Quick apply
The Utilization Review Physician is the lead clinician for the health plan ... Responsible for the administration of medical services for company health plan utilizing the ...
The Utilization Review Physician is the lead clinician for the health plan ... Responsible for the administration of medical services for company health plan utilizing the ...
Quick apply
The Utilization Review Physician is the lead clinician for the health plan ... Responsible for the administration of medical services for company health plan utilizing the ...
The Utilization Review Physician is the lead clinician for the health plan ... Responsible for the administration of medical services for company health plan utilizing the ...
Quick apply
The Utilization Review Physician is the lead clinician for the health plan ... Responsible for the administration of medical services for company health plan utilizing the ...
Carteret, NJ · On-site
$150 - $220/hr
Responsibilities: * The Utilization Review Physician is the lead clinician for the health plan, responsible for the administration of medical services for the company health plan using ...
Carteret, NJ · On-site
$150 - $220/hr
Responsibilities: * The Utilization Review Physician is the lead clinician for the health plan, responsible for the administration of medical services for the company health plan using ...
Strong working knowledge of medical procedures, diagnoses, and procedure codes, including ICD-10, ... Collects and analyzes variances from the plan of care and collaborates with physicians and the ...
Strong working knowledge of medical procedures, diagnoses, and procedure codes, including ICD-10, ... Collects and analyzes variances from the plan of care and collaborates with physicians and the ...
Alpharetta, GA · On-site
Utilization Review Nurse Location: [City, State / Remote] Employment Type: Full-Time Experience: 2 ... Review medical records, physician documentation, treatment plans, and diagnostic results to ...
Alpharetta, GA · On-site
Utilization Review Nurse Location: [City, State / Remote] Employment Type: Full-Time Experience: 2 ... Review medical records, physician documentation, treatment plans, and diagnostic results to ...
Miami, FL · On-site
A strong utilization review professional ensures medical necessity, appropriate level of care ... physician accordingly. · Performs discharge reviews (ISD) of insurance and HMO patient records and ...
Quick apply
Miami, FL · On-site
A strong utilization review professional ensures medical necessity, appropriate level of care ... physician accordingly. · Performs discharge reviews (ISD) of insurance and HMO patient records and ...
Odessa, TX · On-site
... Physician Advisors. Qualifications: A. Education: Holds a current Texas license as a Registered ... Three years of clinical nursing experience in a general medical/surgical setting or appropriate ...
Odessa, TX · On-site
... Physician Advisors. Qualifications: A. Education: Holds a current Texas license as a Registered ... Three years of clinical nursing experience in a general medical/surgical setting or appropriate ...
Odessa, TX · On-site
... Physician Advisors. Qualifications: A. Education: Holds a current Texas license as a Registered ... Three years of clinical nursing experience in a general medical/surgical setting or appropriate ...
Odessa, TX · On-site
... Physician Advisors. Qualifications: A. Education: Holds a current Texas license as a Registered ... Three years of clinical nursing experience in a general medical/surgical setting or appropriate ...
Las Vegas, NV · On-site
Evaluate medical necessity, level of care, and documentation accuracy * Ensure compliance with ... Collaborate with physicians, case management, and care teams * Support discharge planning and care ...
Las Vegas, NV · On-site
Evaluate medical necessity, level of care, and documentation accuracy * Ensure compliance with ... Collaborate with physicians, case management, and care teams * Support discharge planning and care ...
West Chester, PA · On-site
Summary: * The Utilization Review Nurse will provide utilization review for authorization ... Works with physicians in documenting medical care to accurately and completely reflect intensity of ...
New
West Chester, PA · On-site
Summary: * The Utilization Review Nurse will provide utilization review for authorization ... Works with physicians in documenting medical care to accurately and completely reflect intensity of ...
New
Marlboro, NJ · On-site
Review clinical documentation to ensure it supports medical necessity. * Submit clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Marlboro, NJ · On-site
Review clinical documentation to ensure it supports medical necessity. * Submit clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
West Chester, PA · On-site
Summary: * The Utilization Review Nurse will provide utilization review for authorization ... Works with physicians in documenting medical care to accurately and completely reflect intensity of ...
New
West Chester, PA · On-site
Summary: * The Utilization Review Nurse will provide utilization review for authorization ... Works with physicians in documenting medical care to accurately and completely reflect intensity of ...
New
Review clinical documentation to ensure it supports medical necessity. * Submit clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Quick apply
Review clinical documentation to ensure it supports medical necessity. * Submit clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Marlboro, NJ · On-site
Review clinical documentation to ensure it supports medical necessity. * Submit clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Marlboro, NJ · On-site
Review clinical documentation to ensure it supports medical necessity. * Submit clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Marlboro, NJ · On-site
Review clinical documentation to ensure it supports medical necessity. * Submit clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Marlboro, NJ · On-site
Review clinical documentation to ensure it supports medical necessity. * Submit clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Canton, MA · On-site
$55 - $60/hr
This role is responsible for reviewing medical records, evaluating the medical necessity of ... Communicate authorization decisions with physicians, provider offices, hospitals, and healthcare ...
Canton, MA · On-site
$55 - $60/hr
This role is responsible for reviewing medical records, evaluating the medical necessity of ... Communicate authorization decisions with physicians, provider offices, hospitals, and healthcare ...
Tuba City, AZ · On-site
Medical
Dental
Vision
Retirement
Axis Medical Staffing, one of the leading Travel Nursing Companies in the nation, has an immediate Monday - Friday from 8am - 5pm. Callback on weekends/holidays shift Utilization Review opening in ...
Tuba City, AZ · On-site
Medical
Dental
Vision
Retirement
Axis Medical Staffing, one of the leading Travel Nursing Companies in the nation, has an immediate Monday - Friday from 8am - 5pm. Callback on weekends/holidays shift Utilization Review opening in ...
$41.5K - $66.4K
0% of jobs
$66.4K - $91.3K
1% of jobs
$91.3K - $116.2K
1% of jobs
$116.2K - $141.1K
0% of jobs
$141.1K - $166K
3% of jobs
$166K - $191K
3% of jobs
$191K - $215.9K
6% of jobs
$221.2K is the 25th percentile. Wages below this are outliers.
$215.9K - $240.8K
49% of jobs
$257.9K is the 75th percentile. Wages above this are outliers.
$240.8K - $265.7K
17% of jobs
$265.7K - $290.6K
15% of jobs
$290.6K - $315.5K
5% of jobs
$41.5K
$233.5K
$315.5K
A Medical Utilization Review Physician evaluates medical treatments, procedures, and hospital stays to ensure they are necessary, appropriate, and cost-effective. They review patient records, apply clinical guidelines, and collaborate with healthcare providers and insurance companies. Their role helps control healthcare costs while ensuring patients receive proper care. These physicians typically work for insurance companies, hospitals, or government agencies.
To thrive as a Medical Utilization Review Physician, you need a valid medical degree (MD or DO), active state medical license, and strong clinical evaluation and decision-making skills. Familiarity with medical review guidelines, healthcare coding systems (like ICD-10 and CPT), and electronic health record (EHR) platforms is usually required. Excellent written and verbal communication, critical thinking, and attention to detail are vital soft skills for this position. These abilities ensure accurate case assessments, effective collaboration with healthcare teams, and compliance with regulatory standards.
Medical Utilization Review Physicians are primarily responsible for reviewing medical records to determine the appropriateness of healthcare services and ensure they meet established guidelines and medical necessity criteria. On a typical day, you may evaluate case files, document your findings, consult with treating physicians, and communicate with case managers or insurance representatives. The role often involves collaborating with multidisciplinary teams while balancing clinical judgment with regulatory and organizational requirements. This process helps ensure patients receive evidence-based care while also supporting efficient resource use within healthcare systems.

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Vivo HealthStaff provides permanent recruitment services for both clinical and administrative positions in the healthcare sector. Over the past 2 years, our clients have seen a 98% retention rate with Vivo HealthStaff placements.
Health care and social assistance
11 - 50 Employees
Dublin, CA, US
2016