• Remote UM Physician…

    Insight Global (New York, NY)
    … remote Physician Reviewers for a leading health insurance company. The Physician Reviewer will review requests for care before, during, and after ... they use the right templates to keep everything consistent. Physician Reviewers also talk directly with doctors when needed...handle other related tasks as needed. This is a remote position that requires strong attention to detail, clear… more
    Insight Global (12/28/25)
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  • Senior Medical Director Appeals, National Physical…

    Centene Corporation (Jefferson City, MO)
    …STARS metrics + Previous experience with ensuring high quality medical director training to review Medicare UM and appeals, Clinical review quality oversight ... and collaborate with key stakeholders for IRE challenges + Perform medical review activities pertaining to utilization review , quality assurance, and medical… more
    Centene Corporation (12/11/25)
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  • Medical Director - Nat'l UM IP (4x10 hr)

    Humana (Little Rock, AR)
    …this knowledge in their daily work. The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, review of all ... scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities,… more
    Humana (11/07/25)
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  • Clinical Reviewer , Nurse (Medical…

    Evolent (Lansing, MI)
    …the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are ... Medical Director's direction, using independent nursing judgement and decision-making, physician -developed medical policies, and clinical decision-making criteria sets. The… more
    Evolent (12/10/25)
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  • Utilization Management Reviewer , RN…

    Excellus BlueCross BlueShield (Rochester, NY)
    …regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review . Refer to and work closely with Case Management to address member ... and treatment of members' medical health conditions, applying established clinical review criteria, guidelines and medical policies and contractual benefits as well… more
    Excellus BlueCross BlueShield (10/07/25)
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  • Senior Utilization Review Medical Director

    Integra Partners (Troy, MI)
    …& Oversight + Provide day-to-day clinical leadership and oversight to the Utilization Review Medical Director(s) and clinical UM team. + Ensure consistent, ... MD) serves as the clinical and strategic leader for Integra's Utilization Management ( UM ) and Credentialing programs. This is a full-time, 40+ hour per week… more
    Integra Partners (12/03/25)
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  • Physician Advisor

    CommonSpirit Health (Salt Lake City, UT)
    …Summary and Responsibilities** _This position is a hybrid role requiring a mix of remote and on-site work at the five CommonSpirit Hospitals in the Greater Salt Lake ... to relocate to the Salt Lake City Area._ The Physician Advisor reports directly to the Medical Director ...with the Medical Director CDI, Enterprise Director Case Management, UM Hub Director, and Care Coordination Leaders at the… more
    CommonSpirit Health (11/07/25)
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  • Advanced Practice Professional ( Physician…

    University of Michigan (Ann Arbor, MI)
    …Center). + Current DEA registration PA: + Satisfactory completion of a Physician Assistant program accredited by Accreditation Review Commission on Education ... Advanced Practice Professional ( Physician Assistant) Oral and Maxillofacial Surgery Apply Now...of Work** Positions that are eligible for hybrid or mobile/ remote work mode are at the discretion of the… more
    University of Michigan (12/24/25)
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  • Physician Assistant (PA) Interventional…

    University of Michigan (Ann Arbor, MI)
    …or level of difficulty. **Required Qualifications + Satisfactory completion of a Physician Assistant program accredited by Accreditation Review + Commission on ... Physician Assistant (PA) Interventional Radiology - Cross-Sectional Apply...of Work** Positions that are eligible for hybrid or mobile/ remote work mode are at the discretion of the… more
    University of Michigan (12/20/25)
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  • Physician Assistant (PA) Adult Cardiac…

    University of Michigan (Ann Arbor, MI)
    …of their responsibilities. **Required Qualifications + Satisfactory completion of a Physician Assistant program accredited by Accreditation Review Commission on ... PHYSICIAN ASSISTANT (PA) Adult Cardiac Surgery Apply Now...of Work** Positions that are eligible for hybrid or mobile/ remote work mode are at the discretion of the… more
    University of Michigan (12/19/25)
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