Case Management Leader - Fully Remote | Upto $150/hr
mercor · United States · US
Utilization Review
Remote
physician
Nurse
Demand88
Career growth78
Healthcare fit86
Remote potential100
Salary band
USD 100 – 150
5-year outlook
Experienced UM/case management leaders with active licensure and payer criteria expertise should remain in demand, especially for remote contract and AI clinical review roles; full-time roles may trade hourly premium for benefits and stability.
Clinical license
Required
Applicant reach
narrow
Seniority
lead
Employment type
–
Date found
2026-10-03
Intelligence details
Flexible work details
- Side income
- Classified as side-income friendly
- Engagement type
- Contract
- Hours
- Variable hours
- Eligible countries
- United States
- Profession fit
- physician, Nurse
- Rate period
- Hourly
Why this was classified this way
- Contractor
Listing via Himalayas.
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
Worth applying if you are an experienced UM/case management RN or physician advisor with InterQual/MCG expertise and leadership experience; skip if you lack UM experience or active licensure.
Who should apply
Experienced utilization management RNs, case management leaders, physician advisors, and clinicians with payer, ACO, or value-based care UM backgrounds.
CV angle
Frame CV around UM leadership metrics: concurrent/retrospective review volumes, InterQual/MCG/Milliman use, CMS Two-Midnight and observation status expertise, physician advisor program management, denial appeals, care transitions, and any AI/clinical documentation review experience.
Skills to highlight
- Utilization management
- Case management
- InterQual/MCG/Milliman
- CMS Two-Midnight Rule
- Discharge planning
- Physician advisor program management
- Denial appeals/peer-to-peer review
- AI-generated clinical review evaluation
Role summary
Remote contract leadership role overseeing utilization management and case management operations, clinical reviews against payer criteria, physician advisor program, care transitions, and evaluation/annotation of AI-generated medical necessity determinations.
We publish our own intelligence summary, never the full job description. Always confirm details with the employer when you apply.