Licensed Physician Reviewer- Orthopedics - PRN - Remote
Core
Licensed physician reviewer for Utilization Management (UM) cases, covering assigned territories and coordinating care for patients.
Role type
Licensed Physician Reviewer (Orthopedics)
Builds
Utilization management decisions and care coordination for health plan members
Domain
Healthcare / Utilization Management
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Analytical and deductive reasoning, Medical judgment, Problem-solving, Organizational skills, Written and verbal fluency in English, Microsoft Office proficiency
Preferred skills
Hospital medicine experience, Utilization review experience
Technologies
Microsoft Office (Outlook, Excel, Word, PowerPoint)
Responsibilities
Cover specified territories for Delegated UM, Establish 2-3 cases daily per market, Attend health plan and local calls, Participate in weekly PCP and SNF meetings, Advise other physician reviewers
Seniority
Mid-level, hands-on IC