Licensed Physician Reviewer – Pain Management

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

📋 Description

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

• Provide Delegated Utilization Management support for designated territories.

• Manage 2–3 cases daily for each covered market, with a maximum of 6 markets.

• Participate in all 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 with health plan teams and local teams.

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

• Carry out additional responsibilities as assigned or modified by management.

⛳️ Requirements

• Graduate from a recognized medical school with a valid, unrestricted license required.

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

• Board Certification in Pain Management is necessary.

• Preferred two years of experience in hospital medicine.

• At least one year of utilization review experience is preferred.

• Strong analytical and deductive reasoning abilities are essential.

• Good judgment and problem-solving capabilities are required.

• Professional and effective communication skills are necessary.

• Strong organizational abilities are essential.

• Proficient written and verbal communication skills in English.

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

🏝️ Benefits

• Competitive compensation.

• Comprehensive benefits package.

• Opportunities for career development and advancement.

• Excellent work-life balance.

• Opportunities for personal growth.