Utilization Management Physician (UMP) Remote | Full-Time | Florida Compensation: $240,000 base + bonus Schedule: 40 hours/week Work Model: Remote (on-site meetings in Daytona Beach, FL ) Overview ...
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Utilization Management Physician (UMP) Remote | Full-Time | Florida Compensation: $240,000 base + bonus Schedule: 40 hours/week Work Model: Remote (on-site meetings in Daytona Beach, FL ) Overview ...
Quick apply
Utilization Management Physician (UMP) Remote | Full-Time | Florida Compensation: $240,000 base + bonus Schedule: 40 hours/week Work Model: Remote (on-site meetings in Daytona Beach, FL ) Overview ...
West Palm Beach, FL · On-site +1
$69K - $128K/yr
... supervising direct patient care. Assesses, plans, implements, and evaluates care based on age ... Learn more about this agency Duties Help The Utilization Management (UM) Registered Nurse (RN) ...
West Palm Beach, FL · On-site +1
$69K - $128K/yr
... supervising direct patient care. Assesses, plans, implements, and evaluates care based on age ... Learn more about this agency Duties Help The Utilization Management (UM) Registered Nurse (RN) ...
Orlando, FL · Remote
$219K/yr
We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first ... This is a remote position, open to candidates who reside in the United States. While your daily ...
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Orlando, FL · Remote
$219K/yr
We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first ... This is a remote position, open to candidates who reside in the United States. While your daily ...
New
Miami, FL · Remote
$35 - $45.94/hr
You will report into the Supervisor, Utilization Review. Work Location: This is a remote position ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...
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Miami, FL · Remote
$35 - $45.94/hr
You will report into the Supervisor, Utilization Review. Work Location: This is a remote position ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...
Fort Lauderdale, FL · Remote
$80K - $105K/yr
Setting: Fully Remote - Utilization Review Schedule: Full-Time, Monday-Friday Hours: Standard ... Payer/insurance-only Utilization Management experience is not eligible * Minimum 3 years of acute ...
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Fort Lauderdale, FL · Remote
$80K - $105K/yr
Setting: Fully Remote - Utilization Review Schedule: Full-Time, Monday-Friday Hours: Standard ... Payer/insurance-only Utilization Management experience is not eligible * Minimum 3 years of acute ...
Fort Lauderdale, FL · Remote
$80K - $100K/yr
Setting: Fully Remote - Utilization Review Schedule: Full-Time, Monday-Friday Hours: Standard ... Strong understanding of medical necessity, utilization management, healthcare reimbursement, and ...
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Fort Lauderdale, FL · Remote
$80K - $100K/yr
Setting: Fully Remote - Utilization Review Schedule: Full-Time, Monday-Friday Hours: Standard ... Strong understanding of medical necessity, utilization management, healthcare reimbursement, and ...
Tampa, FL · On-site +1
... remote or hybrid work environment. * Licensed as a Registered Nurse in the state of Florida * Three (3) years as a practicing RN. * Utilization Management experience preferred
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Tampa, FL · On-site +1
... remote or hybrid work environment. * Licensed as a Registered Nurse in the state of Florida * Three (3) years as a practicing RN. * Utilization Management experience preferred
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Miami, FL · Remote
$275K - $325K/yr
Utilization Management Medical Director Oncology Work Location ... REMOTE (work from home) California Nevada Arizona Oregon Florida The Medical Director role provides ...
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Miami, FL · Remote
$275K - $325K/yr
Utilization Management Medical Director Oncology Work Location ... REMOTE (work from home) California Nevada Arizona Oregon Florida The Medical Director role provides ...
... utilization management and clinical medical review solutions. We're a leader in Peer and ... This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no minimum ...
... utilization management and clinical medical review solutions. We're a leader in Peer and ... This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no minimum ...
... utilization management and clinical medical review solutions. We're a leader in Peer and ... This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no minimum ...
... utilization management and clinical medical review solutions. We're a leader in Peer and ... This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no minimum ...
... utilization management and clinical medical review solutions. We're a leader in Peer and ... This is a flexible remote opportunity requiring just 1-2 hours per week -with no minimum commitment.
... utilization management and clinical medical review solutions. We're a leader in Peer and ... This is a flexible remote opportunity requiring just 1-2 hours per week -with no minimum commitment.
Key Responsibilities: 1. Leadership and Team Management: * Supervise and mentor a team of ... HBiz complies with all applicable employment laws for remote and multi-state hiring and provides ...
Key Responsibilities: 1. Leadership and Team Management: * Supervise and mentor a team of ... HBiz complies with all applicable employment laws for remote and multi-state hiring and provides ...
Tampa, FL · Remote
$35K - $40K/yr
Managing incoming calls or incoming post services claims work. * Determines contract and benefit ... The position is remote. The training will be onsite in the Tampa office for 1-2 weeks. * 5411 Sky ...
Tampa, FL · Remote
$35K - $40K/yr
Managing incoming calls or incoming post services claims work. * Determines contract and benefit ... The position is remote. The training will be onsite in the Tampa office for 1-2 weeks. * 5411 Sky ...
Pompano Beach, FL · Remote
$50K - $65K/yr
Utilization Review Specialist | Remote | Full-Time $50,000 - $65,000 Annually | Weekdays (Weekend ... In this remote role, you'll manage a caseload of 50-75 patients, conducting admission and ...
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Pompano Beach, FL · Remote
$50K - $65K/yr
Utilization Review Specialist | Remote | Full-Time $50,000 - $65,000 Annually | Weekdays (Weekend ... In this remote role, you'll manage a caseload of 50-75 patients, conducting admission and ...
Pompano Beach, FL · Remote
$45K - $65K/hr
Utilization Review Specialist | Remote | Full-Time $50,000 - $65,000 Annually | Weekdays (Weekend ... In this remote role, you'll manage a caseload of 50-75 patients, conducting admission and ...
Pompano Beach, FL · Remote
$45K - $65K/hr
Utilization Review Specialist | Remote | Full-Time $50,000 - $65,000 Annually | Weekdays (Weekend ... In this remote role, you'll manage a caseload of 50-75 patients, conducting admission and ...
In collaboration with Utilization Management leadership, develop and maintain effective working relationships with contracted providers involved in remote utilization review and physician advisory ...
In collaboration with Utilization Management leadership, develop and maintain effective working relationships with contracted providers involved in remote utilization review and physician advisory ...
... management, quality metrics, cost, and utilization. This role requires a strong balance of ... Non-patient facing * Full time remote * Job must be U.S. based OTHER PHYSICAL REQUIREMENTS * Vision
... management, quality metrics, cost, and utilization. This role requires a strong balance of ... Non-patient facing * Full time remote * Job must be U.S. based OTHER PHYSICAL REQUIREMENTS * Vision
Tampa, FL · Remote
$175K - $185K/yr
What You'll Do Clinical Review & Utilization Management * Perform clinical reviews of dental claims ... Remote role with collaboration across national teams * High-impact role shaping clinical standards ...
Tampa, FL · Remote
$175K - $185K/yr
What You'll Do Clinical Review & Utilization Management * Perform clinical reviews of dental claims ... Remote role with collaboration across national teams * High-impact role shaping clinical standards ...
Davie, FL · On-site +1
$24 - $26/hr
... manages insurance authorization for clients across our PHP and IOP programs - completing pre ... Utilization Review • Insurance Authorization/Precertification • Behavioral Health Case ...
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Davie, FL · On-site +1
$24 - $26/hr
... manages insurance authorization for clients across our PHP and IOP programs - completing pre ... Utilization Review • Insurance Authorization/Precertification • Behavioral Health Case ...
New
... utilization management and clinical medical review solutions. We're a leader in Peer and ... This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no minimum ...
... utilization management and clinical medical review solutions. We're a leader in Peer and ... This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no minimum ...
| Aspect | Remote Supervisor Utilization Management | Remote Utilization Review Nurse |
|---|---|---|
| Credentials | RN, often with management or supervisor certifications | RN, with clinical review certifications |
| Work Environment | Supervises teams, manages utilization processes remotely | Performs clinical reviews, assesses patient necessity remotely |
| Employer & Industry Usage | Health insurance companies, managed care organizations | Insurance companies, third-party administrators |
| Primary Focus | Overseeing utilization management operations | Conducting clinical utilization reviews |
Remote Supervisor Utilization Management roles focus on overseeing utilization management teams and processes, ensuring compliance and efficiency. In contrast, Remote Utilization Review Nurses primarily perform clinical assessments to determine the necessity of services. Both roles require RN credentials but differ in responsibilities and scope within the utilization management field.
Daytona Beach, FL • Remote
Full-time
Medical, Retirement, PTO
Re-posted yesterday
Remote | Full-Time | Florida
Compensation: $240,000 base + bonus
Schedule: 40 hours/week
Work Model: Remote (on-site meetings in Daytona Beach, FL)
Overview
Seeking an experienced Utilization Management Physician to perform medical necessity reviews, peer-to-peer discussions, and clinical determinations using evidence-based criteria.
Responsibilities
Review pre-auths, concurrent reviews, claims, and appeals
Make medical necessity determinations using MCG/InterQual/CMS criteria
Conduct peer-to-peer reviews and support UM staff
Participate in committees and provider education as needed
Requirements
MD or DO with active, unrestricted Florida license
3+ years UM Physician experience
3–7 years clinical experience
Managed care experience required
Available via phone, email, and Teams
Benefits
Bonus opportunity
401(k)
Health benefits
Malpractice coverage
PTO + CME
Licenses, fees, travel, and relocation reimbursed
About Us:
HealthPlus Staffing is National Leader in the Healthcare Staffing Industry. We partner up with top facilities nationwide with the focus of finding them highly qualified candidates.
Our Promise:
If interested in this position, please submit an application or call us at 561-291-7787 to speak with one of our highly experienced consultants. We look forward to finding your next position!
The HealthPlus Team.
Sourced by ZipRecruiter
Recruiting and staffing services
11 - 50 Employees
Boynton Beach, FL, US
2019