Licensed Physician Reviewer – Rheumatology

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

📋 Description

• Administers Delegated Utilization Management (UM) by overseeing the designated territories as assigned.

• Establishes 2-3 cases daily for each market under coverage (up to 6 markets).

• Ensures participation in all health plan and local meetings.

• Participates in the weekly Primary Care Provider (PCP) and Skilled Nursing Facility (SNF) meetings for the assigned territories.

• Provides guidance to fellow physician reviewers.

• Performs additional duties as assigned and modified by the manager.

⛳️ Requirements

• Graduate from an accredited Medical School with a valid, unrestricted license.

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

• Board Certification in Rheumatology.

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

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

• Excellent analytical and deductive reasoning abilities.

• Strong judgment and problem-solving capabilities.

• Professional and effective communication skills.

• Strong organizational abilities.

• Proficient in written and verbal English.

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

🏝️ Benefits

• Competitive compensation.

• Comprehensive benefits package.

• Opportunities for career development and advancement.

• Options for work-life balance.