Licensed Physician Reviewer – Endocrinology

This is a fully remote position, open to applicants in United States.

📋 Description

• Act as the lead physician reviewer for Utilization Management cases.

• Provide Delegated Utilization Management for designated territories, managing 2–3 cases daily for each covered market, up to 6 markets.

• Attend all scheduled health plan and local meetings.

• Engage in weekly meetings with Primary Care Providers and Skilled Nursing Facilities for assigned areas.

• Offer guidance to other physician reviewers.

• Coordinate patient care effectively.

• Contribute to Process and Quality improvement initiatives for Delegated Utilization Management.

• Carry out additional responsibilities as assigned and adjusted by the manager.

⛳️ Requirements

• Must be a graduate from an accredited Medical School with a valid, unrestricted license.

• Completion of a residency in Internal Medicine or Family Practice is required.

• Board Certification in the area of residency is necessary.

• Preferred: Two (2) years of experience in Hospital medicine.

• Preferred: At least one (1) year of experience in utilization review.

• Strong analytical and deductive reasoning abilities are essential.

• Good judgment and effective problem-solving skills are required.

• Professional and effective communication abilities are necessary.

• Strong organizational skills are essential.

• Fluency in English, both written and verbal, is required.

• Proficiency in Microsoft Office applications, including Outlook, Excel, Word, and PowerPoint.

🏝️ Benefits

• Comprehensive benefits package.

• Opportunities for career development and advancement.

• Excellent work-life balance.

• Potential for bonuses or commissions.