Licensed Physician Reviewer (Remote) PRN - Radiology
Core
Primary physician reviewer for Utilization Management (UM) cases, covering specified territories and coordinating care for patients.
Role type
Licensed Physician Reviewer (Utilization Management)
Builds
Delegated Utilization Management decisions for health plans and local teams
Domain
Healthcare / Utilization Management
Deliverable
production ML models | product features | dashboards & analysis | client delivery | physical/clinical work
Required skills
Medical School graduate, valid unrestricted medical license, Internal Medicine or Family Practice residency, Board Certification, analytical and deductive reasoning, judgement and problem-solving, written and verbal fluency in English, Microsoft Office proficiency
Preferred skills
2+ years in Hospital medicine, 1+ year in utilization review
Responsibilities
Cover specified territories and establish 2-3 UM cases daily, attend health plan and local calls, participate in weekly PCP and SNF meetings, advise other physician reviewers, participate in Process and Quality improvement
Seniority
Mid-level, hands-on IC