Physician Reviewer

The Judge Group; United States; Remote; Full time

Job summary

A leading healthcare organization is seeking board-certified Internal or Family Medicine physicians for a remote National Healthcare Recruiting Manager role. This full-time position involves conducting peer reviews and ensuring compliance in a fast-paced environment, offering competitive pay and work-life balance.

Benefits

Medical insurance

Vision insurance

401(k)

Qualifications

• Current/active Board Certification required.
• 5 years of recent Hospitalist experience.
• Clean background/licensure history.

Responsibilities

• Conduct peer-to-peer calls and case reviews.
• Provide evidence-based reviews of medical claims.
• Ensure compliance with state regulations.

Skills

High-level computer skills

Understanding of clinical appropriateness

Experience in utilization management

Education

Board Certification in Family Medicine or Internal Medicine

Job description

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This range is provided by The Judge Group. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$105.00/hr - $110.00/hr

Direct message the job poster from The Judge Group

National Healthcare Recruiting Manager @ The Judge Group | Connecting top healthcare workers with their dream job

Position Type: Temp-to-Perm (W2 contract, then converted to FTE with the client between 3 to 6 months)

Compensation:

• Hourly: $105/hour during temporary phase.
• 40 hours per week, 8-hour shifts staggered between 6am-7pm Mountain Time (8am-9pm EST).
• Participation in a weekend rotation, working at least 3 weekend days per month.
• Schedule provided at least 60 days in advance with little to no flexibility.

We are seeking board-certified Internal Medicine or Family Medicine physicians to join a dynamic team in a fully remote utilization review role. This position involves conducting peer-to-peer calls and case reviews, ensuring compliance with state regulations and delivering evidence-based decisions.

Ideal candidates will have recent direct patient care experience (within the past 6 months), a strong understanding of Utilization Review (UR) processes, and a commitment to making UR their career.

Responsibilities:

• Provide reviews of medical claims on a locum tenens basis.
• Utilize clinical knowledge to provide evidence-based reviews, adjudicating requests for commercial and Medicare D medications.
• Conduct peer reviews to offer informed, objective voices on coverage decisions.
• Stay abreast of emerging technologies by addressing controversial, cutting-edge treatment modalities.

Schedule:

• 40 hours/week, staggered between 6 AM – 7 PM (MST). (8 hours per day)
• Rotational weekend coverage: 3 weekend days per month (days off during the week to compensate).
• Training Period: Three months with minimal time off allowed.

Qualifications:

• Current/active Board Certification in Family Medicine or Internal Medicine by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA).
• 5 years of recent Hospitalist experience.
• Clean background/licensure history.
• Ability to work a set, non-flexible schedule of 40 hours per week, Monday – Friday, rotating between the hours of 6am to 7pm, Mountain Time.
• Willingness to participate in a weekend rotation (3 weekend days per month).
• High-level computer skills, capable of navigating multiple applications simultaneously on 3 monitors.
• Understanding of clinical appropriateness and insurance plan criteria.
• Prior experience in utilization management and peer review programs is highly preferred.
• Ability to sit at a desk for 8 to 10 hours per day and efficiently use a computer, telephone, and other office equipment.

Additional Information:

• This is a busy, full-time, salaried position that requires dedication and hard work.
• Candidates must be willing to make Utilization Review their career.
• The position is not suitable for those looking to semi-retire or work locum tenens only.
• Training for this project is three months with minimal time off allowed during this period.
• Physicians will be provided with a computer and must work from a direct internet connection due to security reasons (no satellite or Wi-Fi).

Seniority level

• Seniority level

  Associate

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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Inferred from the description for this job

Medical insurance

Vision insurance

401(k)

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