Remote Physician Reviewer – Utilization Management (MD/DO)

Medix Staffing Solutions, Inc.; Florida; Remote; USD 265,000 - 275,000; Full time

Benefits offered by this job

Unlimited vacation

11 paid company holidays

Paid sick time

Wellness reimbursements

Parental leave

401(k) plan participation

Life & disability insurance

Comprehensive medical, dental, and vis

Job summary

Medix Staffing Solutions, Inc. is seeking a Board-Certified MD/DO to join a fully remote Utilization Management team. You will assess medical appropriateness for inpatient, outpatient, and pharmacy services using evidence-based guidelines and internal policies.

The role requires 6+ years of clinical practice with 1+ year in utilization review. Salary targets are $265,000–$275,000 per year, plus annual bonuses, comprehensive benefits, unlimited vacation, holidays, and wellness programs.

Qualifications

• Board-certified MD/DO required.
• Active medical license in FL or NC, or eligibility for IMLCC.
• 6+ years of clinical practice.
• 1+ year of utilization review experience in a managed care plan.
• Salary target of $265,000–$275,000 per year with bonuses.

Responsibilities

• Determine medical appropriateness of inpatient, outpatient, and pharmacy services by reviewing clinical information and applying evidence-based guidelines and internal policies.
• Provide timely, high-quality medical reviews and clinical determinations.
• Conduct peer-to-peer discussions with treating providers to clarify information and discuss alternative treatments based on medical necessity.
• Document all communication and decision-making in workflow tools clearly.
• Handle escalated cases and maintain compliance with laws and regulations.

Education

Board-certified MD/DO

Active FL or NC license or IMLCC eligibility

Job description

Medix Staffing Solutions, Inc. is seeking a Board-Certified MD/DO to join a fully remote Utilization Management team. You will assess medical appropriateness for inpatient, outpatient, and pharmacy services using evidence-based guidelines and internal policies.

The role requires 6+ years of clinical practice with 1+ year in utilization review. Salary targets are $265,000–$275,000 per year, plus annual bonuses, comprehensive benefits, unlimited vacation, holidays, and wellness programs.