Licensed Physician Reviewer – Gynecology

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 by overseeing designated territories.

• Establish 2–3 cases daily for each market managed, covering up to 6 markets.

• Attend all health plan meetings and local calls.

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

• Offer guidance to fellow physician reviewers.

• Coordinate patient care effectively.

• Contribute to process and quality enhancements within Delegated Utilization Management.

• Execute additional responsibilities as assigned and adjusted by the manager.

⛳️ Requirements

• A graduate from an accredited Medical School with a valid, unrestricted license is mandatory.

• Successful completion of a residency in Internal Medicine or Family Practice.

• Board Certification in Gynecology is required.

• A minimum of two (2) years’ experience in Hospital medicine is preferred.

• At least one (1) year of experience in utilization review is preferred.

• Strong analytical and deductive reasoning abilities.

• Good judgment and problem-solving capabilities.

• Professional and effective communication skills are essential.

• Excellent organizational skills.

• Proficient in written and verbal English.

• Familiarity with Microsoft Office applications such as Outlook, Excel, Word, and PowerPoint is required.

🏝️ Benefits

• Competitive compensation.

• Comprehensive benefits package.

• Opportunities for career development and advancement.

• Excellent work-life balance.

• Potential for growth within the company.

• Eligibility for bonus or commission may apply.