Physician Reviewer - Utilization Management (Part Time)

📋 Description

• Determine medical appropriateness of inpatient, outpatient, and pharmacy services using evidence-based guidelines.
• Review clinical information to support medical determinations.
• Document decisions clearly in Oscar workflow tools for member readability.
• Use correct templates when documenting decisions during case reviews.
• Meet turnaround times for clinical reviews.
• Conduct timely peer-to-peer discussions with treating providers to explain decisions.

🎯 Requirements

• Board certification as an MD or DO.
• Licensed in FL, NC, or AZ, or hold an active Interstate Medical Licensure Compact (IMLC).
• 6+ years of clinical practice.

🎁 Benefits

• Medical, dental, and vision benefits.
• 11 paid holidays.
• Paid sick time.
• Paid parental leave.
• 401(k) plan participation.
• Life and disability insurance.