Licensed Physician Reviewer – Urologist

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

📋 Description

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

• Provide guidance to other physician reviewers.

• Participate in daily calls with health plan teams and local teams that support this function.

• Oversee patient care coordination.

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

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

• Ensure participation in all health plan and local calls.

• Join weekly meetings for Primary Care Providers (PCP) and Skilled Nursing Facilities (SNF) relevant to the assigned territories.

⛳️ 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 essential.

• Board Certification in the specialty area of Urology is required.

• Preferred experience includes two (2) years in Hospital medicine.

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

• Must possess excellent analytical and deductive reasoning abilities.

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

• Professional and impactful communication skills are required.

• Strong organizational capabilities are essential.

• Fluency in written and spoken English is mandatory.

• Proficiency in Microsoft Office applications such as Outlook, Excel, Word, and PowerPoint is required.

🏝️ Benefits

• Competitive compensation package.

• Comprehensive benefits.

• Opportunities for career development and advancement.

• A focus on work-life balance.