Physician Reviewer – Utilization Management

This is a fully remote position, open to applicants in Arizona, +2 more states.

📋 Description

• Assess the medical suitability of inpatient, outpatient, and pharmacy services by analyzing clinical data and implementing evidence-based guidelines.

• Deliver prompt medical evaluations that adhere to Oscar's rigorous quality standards.

• Make clinical decisions grounded in evidence-based criteria, Oscar's internal protocols, and your clinical expertise.

• Accurately document all communications and decision-making processes using Oscar's workflow tools.

• Utilize the appropriate templates for recording decisions during case evaluations.

• Adhere to designated turnaround times for clinical assessments.

• Engage in timely peer-to-peer discussions with healthcare providers to clarify clinical details and communicate review outcome decisions.

• Ensure compliance with all relevant laws and regulations.

⛳️ Requirements

• Board certification as a Doctor of Medicine (MD) or Doctor of Osteopathy (DO).

• Must be licensed in one of the following states: FL, NC, AZ, or hold an active Interstate Medical Licensure Compact (IMLC).

• Minimum of 6 years of clinical practice experience.

🏝️ Benefits

• Health insurance.

• Participation in a 401(k) plan.

• Paid parental leave.

• Paid sick leave.

• Paid time off.

• 11 paid holidays.

• Unlimited vacation.

• Annual performance bonuses.