Licensed Physician Reviewer, Ophthalmology

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

📋 Description

• Serve as the lead physician reviewer for Utilization Management (UM) cases within our organization.

• Provide guidance to fellow physician reviewers and participate in daily discussions with health plan teams.

• Oversee patient care coordination.

• Handle 2-3 cases daily for each market served (up to 6 markets).

• Ensure participation in all health plan and local meetings.

• Engage in Process and Quality improvement initiatives in Delegated Utilization Management.

⛳️ Requirements

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

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

• Board Certification in Ophthalmology 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.

🏝️ Benefits

• Health insurance.

• Retirement plans.

• Paid time off.

• Flexible working arrangements.

• Opportunities for professional development.

• Bonuses.