Remote Physician Reviewer Part-Time Utilization Management

name; New York (NY); On-site; USD 179,088 - 199,752; Part time

Job summary

Oscar is hiring a part-time Physician Reviewer to join our Utilization Management team. You will determine medical appropriateness of inpatient, outpatient, and pharmacy services by reviewing clinical information and applying evidence-based guidelines.

This remote role is open to candidates in the United States, with a minimum commitment of 20 hours per week and a call rotation. Base pay is $130–$145 per hour, with final offer based on skills and experience.

Qualifications

• Board-certified MD or DO.
• Active medical license in FL, NC, AZ or IMLC.
• 6+ years of clinical practice.

Responsibilities

• Provide timely medical reviews that meet Oscar’s stringent quality parameters.
• Provide clinical determinations based on evidence-based criteria and Oscar internal guidelines and policies.
• Clearly and accurately document all communication and decision-making in Oscar workflow tools.
• Use correct templates for documenting decisions during case review.
• Meet the appropriate turn‑around times for clinical reviews.
• Receive and review escalated reviews.
• Conduct timely peer-to-peer discussions with treating providers to clarify clinical information and to explain review outcome decisions.

Education

MD or DO board-certified

Job description

Oscar is hiring a part-time Physician Reviewer to join our Utilization Management team. You will determine medical appropriateness of inpatient, outpatient, and pharmacy services by reviewing clinical information and applying evidence-based guidelines.

This remote role is open to candidates in the United States, with a minimum commitment of 20 hours per week and a call rotation. Base pay is $130–$145 per hour, with final offer based on skills and experience.