Physician Reviewer (Part -Time) - Utilization Management

📋 Description

• Provide timely medical reviews that meet Oscar's stringent quality parameters.
• Provide clinical determinations based on evidence-based criteria and Oscar internal guidelines and
• Clearly and accurately document all communication and decision-making in Oscar workflow tools
• Use correct templates for documenting decisions during case review.
• Meet the appropriate turn-around times for clinical reviews.
• Receive and review escalated reviews.

🎯 Requirements

• Board certification as an MD or DO
• Licensed in one of these states: FL, NC, AZ OR possess an active Interstate Medical Licensure
• 6+ years of clinical practice

🎁 Benefits

• Bonus points: Licensure in multiple Oscar states
• 1+ years of utilization review experience in a managed care plan (health care industry)
• BC in Cardiology, Radiation/Oncology, or Neurology
• Experience with care management within the health insurance industry.
• Willing and able to obtain additional state licensure as needed, with Oscar's support
• Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11