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Remote Physician Advisor Utilization Review Jobs in Springfield, MA

Remote Tax Manager

Stafford, CT ยท Remote

$150K - $170K/yr

Job Title: Remote Tax Manager Job ID: 1050602 Date Posted: July 28, 2026 Employment Type ... Review financials to identify missed planning opportunities and advise on entity structuring and ...

... for optimal utilization of applications. Develops system test plans and performs testing of ... inpatient physician workflows, Epic Inpatient applications, build enhancements, workflow ...

... for optimal utilization of applications. Develops system test plans and performs testing of ... inpatient physician workflows, Epic Inpatient applications, build enhancements, workflow ...

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Remote Physician Advisor Utilization Review information

See Springfield, MA salary details

$13

$24

$34

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

As of Aug 22, 2026, the average hourly pay for remote physician advisor utilization review in Springfield, MA is $24.59, according to ZipRecruiter salary data. Most workers in this role earn between $20.14 and $26.83 per hour, depending on experience, location, and employer.

What is a remote physician advisor utilization review?

A Remote Physician Advisor Utilization Review is a licensed physician who works remotely to review medical cases and determine if the healthcare services provided are medically necessary and meet insurance or regulatory requirements. They collaborate with clinical and administrative staff, analyze patient records, and provide recommendations on care levels, admissions, and compliance. This role helps healthcare organizations ensure appropriate resource utilization, reduce denials, and maintain quality patient care while working offsite.

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

To thrive as a Remote Physician Advisor Utilization Review, you need a medical degree (MD/DO), active physician licensure, and deep knowledge of clinical guidelines and utilization management. Familiarity with medical necessity criteria (such as InterQual or MCG), electronic health record (EHR) systems, and URAC/NCQA standards is typically required. Excellent communication, analytical thinking, and the ability to work independently are vital soft skills in this position. These competencies ensure accurate medical necessity determinations, regulatory compliance, and effective collaboration with healthcare teams while working remotely.

What are some of the common challenges faced by remote physician advisors in utilization review, and how can they be addressed?

Remote Physician Advisors in Utilization Review often encounter challenges such as interpreting complex clinical documentation, navigating varying payer requirements, and maintaining effective communication with on-site care teams. To address these, it's important to stay updated on payer guidelines, use secure collaboration tools to connect with hospital staff, and participate in ongoing training to enhance clinical review skills. Building strong working relationships with case managers and consistently documenting your recommendations can also help overcome these hurdles and ensure efficient, high-quality reviews.

What is the difference between Remote Physician Advisor Utilization Review vs Remote Medical Director?

AspectRemote Physician Advisor Utilization ReviewRemote Medical Director
Primary RoleReview and approve medical necessity and utilization of healthcare servicesOversee clinical operations, policy development, and provider performance
CredentialsMedical degree, medical license, often board-certified in a specialtyMedical degree, medical license, often with leadership experience
Work EnvironmentRemote, insurance companies, healthcare organizationsRemote or onsite, healthcare organizations, hospitals, insurance companies
Industry UsageCommonly used in utilization management and insurance sectorsUsed in healthcare administration and leadership roles

While both roles require medical credentials and involve healthcare oversight, the Remote Physician Advisor Utilization Review focuses on evaluating medical necessity and utilization, whereas the Remote Medical Director oversees broader clinical operations and policy development. The former is more specialized in utilization review tasks, while the latter involves leadership responsibilities within healthcare organizations.

How do you get into remote physician advisor utilization review?

To become a remote physician advisor in utilization review, candidates typically need a medical degree, valid medical license, and experience in clinical practice or healthcare management. Additional certifications such as Certified Physician Executive (CPE) or Certified Professional in Healthcare Quality (CPHQ) can enhance prospects. Strong knowledge of insurance policies, medical coding, and utilization review processes is essential, along with excellent communication skills for remote work environments.

What are popular job titles related to Remote Physician Advisor Utilization Review jobs in Springfield, MA?

For Remote Physician Advisor Utilization Review jobs in Springfield, MA, the most frequently searched job titles are:

What job categories do people searching Remote Physician Advisor Utilization Review jobs in Springfield, MA look for?

The top searched job categories for Remote Physician Advisor Utilization Review jobs in Springfield, MA are:

What cities near Springfield, MA are hiring for Remote Physician Advisor Utilization Review jobs?

Cities near Springfield, MA with the most Remote Physician Advisor Utilization Review job openings:

Board Certified Behavior Analyst (BCBA) - Remote

All Care Therapies

Hartford, CT โ€ข Remote

$43 - $56/hr

Part-time

Posted 14 days ago


Job description



All Care Therapies is a leading provider of Physical, Occupational, Speech, and ABA therapy services, delivering care through virtual, in-home, and clinic-based settings across California, Texas, and Nevada. We serve individuals of all ages, combining innovative technology with a collaborative, patient-centered approach. Our dedicated clinicians provide flexible, high-quality care that meets patients where they are, supporting recovery, enhancing communication, and driving meaningful, long-term outcomes.


Job Description


The Board Certified Behavior Analyst (BCBA) is a licensed clinical professional responsible for designing, implementing, supervising, and evaluating Applied Behavior Analysis (ABA) therapy programs for patients across the lifespan. The BCBA at ACT works in alignment with our mission to deliver individualized, compassionate care and maintains clinical excellence in accordance with the BACB's ethical and professional standards.

This role may be performed via tele health, in a clinic environment, in the patient's home, or on-site at a school or care facility — providing maximum flexibility to match the BCBA's preferred work style with ACT's patient population needs.


Qualifications


Clinical Practice

  • Conduct comprehensive functional behavior assessments (FBA) and skill assessments (e.g., VB-MAPP, ABLLS-R, PEAK) to identify treatment priorities.
  • Develop individualized ABA treatment plans with measurable goals based on assessment findings, patient needs, and family priorities.
  • Design, implement, and modify behavior intervention plans (BIPs) using evidence-based ABA methodologies.
  • Deliver direct ABA therapy services to patients as clinically indicated and within the scope of the BCBA's practice.
  • Monitor patient progress through consistent data collection and analysis; adjust treatment plans accordingly.
  • Collaborate with interdisciplinary team members including SLPs, OTs, PTs, physicians, and educators to coordinate holistic care.

Supervision & Team Leadership

  • Supervise and mentor Registered Behavior Technicians (RBTs) and BCaBA candidates in accordance with BACB supervision requirements.
  • Provide ongoing training, performance feedback, and professional development support to supervisees.
  • Conduct regular session observations and ensure fidelity to treatment plans across all service settings.

Documentation & Compliance

  • Complete all clinical documentation accurately and within required timeframes, including session notes, progress reports, treatment plans, and authorization requests.
  • Maintain compliance with all applicable federal, state, and payer-specific regulations, including HIPAA and Medicaid/insurance billing standards.
  • Participate in utilization review and authorization processes in coordination with ACT's billing and operations teams.

Family & Caregiver Collaboration

  • Provide caregiver training and coaching to support generalization of ABA strategies across home, school, and community settings.
  • Engage families as active partners in treatment planning and progress review.
  • Conduct regular parent/caregiver meetings to review goals, data trends, and next steps.

Requirements:

  • Active BCBA certification in good standing with the BACB
  • Active state licensure where required by the state of practice
  • Master's degree in Applied Behavior Analysis, Psychology, Education, or a related field
  • Minimum 2 years of ABA clinical experience, including direct therapy and supervision
  • Proficiency in ABA assessment tools (FBA, VB-MAPP, ABLLS-R, or equivalent)
  • Experience with electronic health records (EHR) and data collection platforms
  • Excellent written and verbal communication skills
  • Ability to obtain a background clearance per ACT and state requirements

Why Join Us

  • We are a therapist-owned and operated organization
  • Career Advancement - We believe in recognizing high-performing teams
  • Efficient web-based documentation system
  • Growing company in a new model of service delivery
  • Monthly team meetings
  • Supportive collaboration with the Clinical team and Supervisors
  • Training, assessments, and materials provided


Additional information


All your information will be kept confidential according to EEO guidelines.


All Care Therapies is an equal opportunity employer. All aspects of employment, including the decision to hire, promote, discipline, or discharge, will be based on merit, competence, performance, and business needs. We do not discriminate based on race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law.