Physician Reviewer - Utilization Management

📋 Description

• Determine medical appropriateness of inpatient, outpatient, and pharmacy services.
• Review clinical data and apply evidence-based guidelines.
• Document decisions clearly in Oscar workflow tools for patient reference.
• Use templates for case review and ensure proper turnaround times.
• Engage in peer discussions with treating providers when needed.
• Adhere to applicable laws and regulations.

🎯 Requirements

• Board certification as an MD or DO
• Licensed in FL, NC, AZ with IMLC active
• 6+ years of clinical practice

🎁 Benefits

• Remote work from US home office
• Base pay $219,000 - $286,902 per year
• Employee benefits and performance bonuses