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Remote Medical Utilization Review Physician Jobs

Silver Cross Hospital

Utilization Review Nurse

New Lenox, IL · On-site +1

$34.73 - $45.15/hr

Performs medical record review for severity of illness and intensity of service; liaison function ... Refers to designated physician advisor those patients not meeting criteria as well as quality of ...

Franciscan Health

Utilization Review Coordinator

... medical necessity, and reviews for appropriateness of setting and utilization. WHO WE ARE With 11 ... Communicate with physicians, patients, members of the Healthcare team, Coordinated Business Office ...

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How much do remote medical utilization review physician jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for remote medical utilization review physician in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What are some common challenges faced by remote medical utilization review physicians, and how can they be managed?

Remote Medical Utilization Review Physicians often encounter challenges such as navigating complex insurance policies, staying updated with evolving clinical guidelines, and communicating effectively with healthcare providers who may have differing opinions. Managing these challenges typically involves continuous education, leveraging decision-support tools, and developing strong written and verbal communication skills to explain decisions clearly. Additionally, working remotely requires efficient time management and the ability to maintain focus in a virtual environment, often supported by collaboration platforms and regular check-ins with the broader review team.

What does a remote medical utilization review physician do?

A Remote Medical Utilization Review Physician evaluates medical records and treatment plans to determine the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. Working remotely, they review clinical documentation, apply evidence-based guidelines, and make recommendations regarding approvals or denials of insurance claims. They also collaborate with healthcare providers, case managers, and insurance companies to ensure patients receive appropriate care while managing healthcare costs. This role is vital in maintaining high standards of patient care and compliance with regulations.

What are the key skills and qualifications needed to thrive as a remote medical utilization review physician?

To thrive as a Remote Medical Utilization Review Physician, you need a valid medical degree (MD or DO), active medical license, and thorough knowledge of clinical guidelines and insurance regulations. Familiarity with electronic medical record systems, utilization management software, and board certification in a relevant specialty are typically required. Excellent analytical thinking, attention to detail, and strong written and verbal communication skills help ensure objective and effective case reviews. These competencies are essential for accurately assessing medical necessity, ensuring compliance, and supporting quality patient care while managing healthcare costs.

What is the difference between Remote Medical Utilization Review Physician vs Remote Medical Case Manager?

AspectRemote Medical Utilization Review PhysicianRemote Medical Case Manager
CredentialsMedical degree, medical license, certification in utilization reviewNursing or social work degree, case management certification
Work EnvironmentPerforming reviews, analyzing medical records remotelyCoordinating care, communicating with providers and patients remotely
Employer & IndustryInsurance companies, third-party administrators, healthcare organizationsInsurance companies, healthcare providers, case management firms

The Remote Medical Utilization Review Physician primarily evaluates medical necessity and approves or denies treatment requests, requiring medical licensure and certification. In contrast, the Remote Medical Case Manager focuses on coordinating patient care and facilitating communication between providers and patients, often with nursing or social work credentials. Both roles are remote, serve the healthcare and insurance industries, but differ in their core responsibilities and required qualifications.

More about Remote Medical Utilization Review Physician jobs
What cities are hiring for Remote Medical Utilization Review Physician jobs? Cities with the most Remote Medical Utilization Review Physician job openings:
What are the most commonly searched types of Medical Utilization Review Physician jobs? The most popular types of Medical Utilization Review Physician jobs are:
What states have the most Remote Medical Utilization Review Physician jobs? States with the most job openings for Remote Medical Utilization Review Physician jobs include:
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Remote Medical Utilization Review Physician jobs near you
Infographic showing various Remote Medical Utilization Review Physician job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Physician Reviewer - Orthopedic Spine Surgery (Utilization Review)

Dane Street, LLC

New York, NY • On-site, Remote

Contractor

Re-posted 6 hours ago

Job description

Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers. We are currently seeking Board-Certified Orthopedic Spine Surgeons with an active New York medical license and Workers' Compensation Board Certification to conduct Utilization Reviews.
This is a fully remote, non-clinical role offering supplemental income with flexible scheduling. Physicians provide objective, evidence-based opinions on the medical necessity of treatment requests and appeals. No patient contact, no treatment, and no doctor-patient relationship is established.
Key Responsibilities:
  • Review medical records to determine the medical necessity of services
  • Utilize state-specific workers' compensation guidelines and nationally recognized criteria
  • Submit clear, concise, and well-supported determinations
  • Complete reviews within required timeframes (typically 1-5 business days)
  • Participate in peer-to-peer calls as needed (coordinated by Dane Street)
  • Complete addenda when new information is provided

Role Highlights:
  • Independent contractor (1099) status
  • Average case takes 15 minutes or less
  • Flat rate per case - consistent, supplemental income
  • Fully remote - work from anywhere
  • You control volume and availability
  • No direct patient interaction or treatment
  • Chronological, pre-organized medical records provided
  • User-friendly portal and streamlined case management
  • Full onboarding and ongoing support included

Requirements:
  • Board Certification in Orthopedic Surgery (Spine focus preferred)
  • Active, unrestricted New York medical license
  • Workers' Compensation Board Certification (New York)
  • Active clinical practice

About Dane Street:
Dane Street is a national leader in Utilization Review and Independent Medical Review services. We partner with highly qualified, actively practicing physicians to ensure high-quality, evidence-based clinical decisions that support better outcomes across the healthcare system.
Apply today to join our Physician Review Panel and start earning on your schedule.

Apply