Remote Utilization Management Physician Reviewer

ExamWorks UM Strategies; United States; Remote; USD 180,000 - 230,000; Full time

Benefits offered by this job

Remote work

Secure online portal

Paperless workflow

Job summary

ExamWorks is seeking a Board Certified physician (Family Medicine or Internal Medicine) to join as a Utilization Management Physician Reviewer in a full-time, 100% remote role. The schedule is Monday through Friday, 8:30am–5:00pm, with occasional weekend/holiday coverage adjusted within the week.

You will work with the Medical Director and clients to review utilization management cases, ensure appropriate use of resources, and provide clear, well-documented decisions that align with medical

Qualifications

• MD or DO degree with active board certification in Family Medicine or Internal Medicine.
• Minimum 1 year of experience in Utilization Management or Peer Reviews for Commercial Payor.
• Active, unrestricted medical license in the United States.
• 5+ years of clinical practice experience, including residency.

Responsibilities

• Perform utilization management reviews accurately and efficiently.
• Review appeals or complaints related to medical review decisions.
• Collaborate with Medical Director and Senior Management to coordinate client services.
• Communicate review outcomes to client Medical Directors and stakeholders; explain changes as needed.
• Participate in quality improvement of all steps in the review process.
• Act as a medical resource and provide guidance to Pharmacists and other team members.

Skills

Utilization Management experience

MD/DO medical background

Education

MD or DO degree

Job description

ExamWorks is seeking a Board Certified physician (Family Medicine or Internal Medicine) to join as a Utilization Management Physician Reviewer in a full-time, 100% remote role. The schedule is Monday through Friday, 8:30am–5:00pm, with occasional weekend/holiday coverage adjusted within the week.

You will work with the Medical Director and clients to review utilization management cases, ensure appropriate use of resources, and provide clear, well-documented decisions that align with medical