Licensed Physician Reviewer - Urologist , PRN (remote)
Core
Primary physician reviewer for Utilization Management (UM) cases, covering specified territories and coordinating care for patients.
Role type
Licensed Physician Reviewer (Urologist)
Builds
Delegated Utilization Management decisions for health plans and local teams
Domain
Healthcare / Utilization Management
Required skills
Medical School graduate, valid unrestricted medical license, Internal Medicine or Family Practice residency, Board Certification in Urology, analytical and deductive reasoning, judgement and problem-solving, written and verbal fluency in English, Microsoft Office proficiency
Preferred skills
Hospital medicine experience, utilization review experience
Responsibilities
Provide Delegated UM by covering assigned territories, establish 2-3 cases a day per market, attend health plan and local calls, participate in weekly PCP and SNF meetings, advise other physician reviewers
Seniority
Mid-level, specialized clinical role