Medical Doctor

ExamWorks; United States; Remote; USD 200,000 - 250,000; Full time

Benefits offered by this job

Work remotely

Secure online portal

Paperless workflow

Job summary

A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or DPM degree with active board certification and unrestricted medical license in relevant states. The role involves performing detailed reviews of medical cases while ensuring high standards of patient care. Responsibilities include collaborating with management and providing guidance on clinical questions. This is a unique opportunity to work from home while contributing to quality medical reviews.

Qualifications

• 5+ years of clinical practice experience, including residency.
• Unrestricted medical licensure in specified states or IMLCC.

Responsibilities

• Perform utilization management reviews accurately.
• Communicate review outcomes to stakeholders.
• Collaborate with the Medical Director and team.
• Audit cases and provide quality feedback.

Skills

Clinical guidance

Medical terminology

Communication

Attention to detail

Ability to work under pressure

Education

MD, DO, or DPM degree

Active board certification in an ABMS or AOA-recognized specialty

Job description

Physician Recruiter - Seeking Medical Professionals for Peer Review Services! Let's connect!

Are you a Family Medicine or an Internal Medicine Physician looking for a full‑time, remote job in a non‑clinical setting? Then let me introduce you to ExamWorks!

ExamWorks is seeking a physician board‑certified in either Family Medicine, Internal Medicine, Obstructics and Gynecology, or Emergency Medicine to join the team full‑time as a Utilization Management Physician Reviewer. We are looking for physicians with an active medical license in the following states: Florida, Wisconsin, Arkansas, Kentucky, Oregon, Nevada, Texas or those who are active with IMLCC.

This position is 100% remote with a schedule of Monday through Friday 8:30 am‑5:00 pm. You must be able to work one weekend a month (adjustments will be made to your Monday through Friday schedule that week.)

The Utilization Management Physician will be responsible for providing thorough and accurate reviews of utilization management cases to ensure the appropriate use of medical resources while continuing to hold high standards of patient care. The position will involve collaborating closely with the Medical Director, other team members, and clients to conduct reviews with a high level of accuracy and efficiency. This collaboration ensures that reviews are thorough, well documented, and align with established medical guidelines and standards.

Opportunity Highlights

• Work remotely
• Secure, easy‑to‑use online portal
• Paperless workflow requiring no medical record filing or storage

Responsibilities

• Perform utilization management reviews in an efficient and timely manner, ensuring each review is completed with careful attention to detail while maintaining high quality work.
• Review appeals or complaints that relate to medical review decisions by conducting a thorough assessment of all medical records, treatment plans, and other supporting documents from healthcare providers.
• Collaborate with the Medical Director and Senior Management to ensure effective coordination of the delivery of services to clients.
• Communicate with client Medical Directors and other stakeholders regarding the utilization management process; provide detailed explanation of review outcomes, address questions and concerns and ensure all parties are aware of any changes or updates in the process.
• Participate in the quality improvement of all steps in the review process.
• Act as a medical resource and provide guidance to Pharmacists and other team members regarding clinical questions.
• Communicate clearly and professionally with clients at regular meetings regarding quality and production.
• Audit cases and provide quality feedback as needed.
• Perform all other duties as assigned by management.

Requirements

• MD, DO, or DPM degree
• Active board certification in an ABMS or AOA‑recognized specialty (MD or DO)
• Active, unrestricted medical licensure in Florida, Wisconsin, Arkansas, Kentucky, Oregon, Nevada, Texas or active with IMLCC
• 5+ years of clinical practice experience (including residency!)
• Ability to work within the United States

Qualification Expectations

• Ability to provide clinical guidance regarding the quality and/or clinical aspects of reviews and, when appropriate, directly communicate with reviewers, staff, and/or clients.
• Ability to interact with clients as needed, either independently or as a participating member of a group discussion between service and client, regarding the clinical quality aspects of the medical reviews.
• Must be able to review cases and data thoroughly to ensure that all necessary information meets quality standards.
• Must have strong knowledge of medical terminology and procedures, which may include utilization reviews, quality‑assurance services compliance, and claims analysis.
• Must have knowledge of federal and/or state legislative mandates (ERISA and/or state law).
• Must be able to work well under pressure and or stressful conditions.
• Must possess the ability to manage change, delays, or unexpected events appropriately.
• Must be able to maintain confidentiality.
• Ability to follow all company policies and procedures in effect at time of hire and as they may change or be added from time to time.

About ExamWorks

We are a URAC accredited independent review organization with a robust network of physician reviewers across all specialties. Our company provides peer review services to a variety of clients including health plans, disability insurers, and workers’ compensation insurers.

Discover why ExamWorks is the largest credentialed expert medical panel in the industry today!