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Um Clinical Reviewer Jobs (NOW HIRING)

mycenters

UM Clinical Reviewer

Pompano Beach, FL

The Utilization Management Clinical Reviewer works within a multidisciplinary team to help identify and manage members who are in need of additional care or support in their home to improve their ...

Medix

Clinical Reviewer

Phoenix, AZ · On-site

$150/hr

Job Summary Our client is seeking a Clinical Reviewer for the CO SUD project starting in August ... Utilization Management (UM) experience, including familiarity with medical necessity reviews, pre ...

Alignment Health

Through remote access to our web-based Portal, UM Medical Director/Physician Advisors will complete clinical reviews for medical necessity, treatment appropriateness and compliance. GENERAL DUTIES ...

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As of Sep 10, 2026, the average hourly pay for um clinical reviewer in the United States is $35.92, according to ZipRecruiter salary data. Most workers in this role earn between $31.25 and $40.38 per hour, depending on experience, location, and employer.

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Infographic showing various Um Clinical Reviewer job openings in the United States as of August 2026, with employment types broken down into 3% As Needed, 74% Full Time, 15% Part Time, and 8% Contract. Highlights an 85% Physical, 1% Hybrid, and 14% Remote job distribution, with an average salary of $74,707 per year, or $35.9 per hour.

UM Clinical Reviewer

Pompano Beach, FL

mycenters
See more jobs at mycentersexternal

Full-time

Re-posted 17 days ago

Job description

One of the fastest growing Managed Long-Term Care company in New York, Centers Plan For Healthy Living is currently accepting applications for Full Time Registered Nurse without experience.

The Utilization Management Clinical Reviewer works within a multidisciplinary team to help identify and manage members who are in need of additional care or support in their home to improve their quality of life. Utilization Management Clinical Reviewer will assess and process all authorization requests to determine medical necessity to ensure all care services, member education, and preventative interventions are maintained.


Qualifications:

  • Active RN license, entry level RN welcome
  • Excellent written and verbal communication skills
  • Ability to meet tight deadlines
  • Strong problem solving skills
  • Proficient in the use of Microsoft office Suite tools

Who We Are: Centers Plan for Healthy Living’s fundamental mission is to enroll eligible individuals who are either Medicaid or Medicaid/Medicare recipients and optimize their ability to remain in the community rather than being institutionalized. Centers Plan for Healthy Living will accomplish this using a multi-pronged approach to care management including ongoing assessment of members’ care/social needs, developing a “living care plan” that is modified as needed, working with community providers as well as the members and their families/care decision makers. We view the member-centric care team as the collective of providers of care, care decision-makers and Centers Plan for Healthy Living care managers and believe that coordinating high quality clinical and social services will result in better clinical outcomes and independent living for the member.

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