Senior PM&R Physician - Remote Medicaid Rehab Expert

Gainwell Technologies; California; Hybrid; USD 177,000 - 253,000; Full time

Benefits offered by this job

Flexible vacation policy

401(k) employer match

Comprehensive health benefits

Educational assistance

Job summary

Gainwell Technologies is seeking a PM&R physician to provide senior clinical expertise and oversight for rehabilitation programs. You will support medical necessity determinations, engage with providers, and contribute to clinical policy development and quality initiatives for rehabilitation services and DME.

You will serve as a trusted clinical advisor to clients and internal teams, guiding decisions to promote high‑quality, cost‑effective care within Medicaid programs.

Qualifications

• MD or DO with active U.S. license and PM&R board certification.
• Minimum 5+ years in rehabilitation medicine or related fields.
• Strong knowledge of rehabilitation services, therapies, DME, prosthetics, and guidelines.

Responsibilities

• Serve as physician subject matter expert for PM&R and rehabilitation programs.
• Review complex authorization requests, medical necessity determinations and related services.
• Conduct peer‑to‑peer consultations with providers using evidence‑based criteria.
• Provide clinical guidance to utilization management, quality and operations teams.
• Interpret Medicaid regulations and clinical policies to ensure compliance.
• Collaborate with clients and internal stakeholders to improve outcomes and access.

Skills

PM&R expertise

Clinical decision‑making

Analytical skills

Communication skills

Education

MD or DO degree

Active CA medical license

PM&R board certification

Job description

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Date: Oct 9, 2026

Location:

Any city, CA, US, 99999

Work Mode: Virtual (Exception only)

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.

Summary

As a Physical Medicine & Rehabilitation (PM&R Physician) at Gainwell, you will provide senior-level clinical expertise and oversight for Physical Medicine & Rehabilitation (PM&R) programs. This role supports medical necessity determinations, provider engagement, clinical policy development, and quality improvement initiatives related to rehabilitation services, pain management, functional restoration, and durable medical equipment (DME). The Advisor Medical Expert serves as a trusted clinical advisor to clients, providers, and internal teams to promote high-quality, cost-effective healthcare outcomes.

Your role in our mission

• Serve as the physician subject matter expert for Physical Medicine & Rehabilitation, rehabilitation services, and functional restoration programs.
• Review complex authorization requests, appeals, and medical necessity determinations related to rehabilitation therapies, inpatient rehabilitation, DME, prosthetics, orthotics, and pain management services.
• Conduct peer-to-peer consultations with providers and apply evidence-based clinical criteria to support appropriate care decisions.
• Provide clinical guidance to utilization management, quality, case management, and operational teams.
• Interpret and apply Medicaid regulations, medical policies, and rehabilitation treatment guidelines to support program compliance.
• Collaborate with clients and internal stakeholders to improve healthcare outcomes, quality initiatives, and member access to rehabilitation services.

What we're looking for

• Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) with an active, unrestricted U.S. medical license.
• Active, unrestricted license to practice medicine in the State of California required.
• Board Certification in Physical Medicine & Rehabilitation (PM&R).
• Minimum of 8+ years of post-residency clinical experience in rehabilitation medicine, functional restoration, musculoskeletal conditions, disability management, or pain management.
• Strong knowledge of rehabilitation services, physical therapy, occupational therapy, speech therapy, DME, prosthetics, orthotics, and evidence-based clinical guidelines.
• Experience with Medicaid programs, utilization management, prior authorization, appeals, or medical review activities, with strong analytical, communication, and decision-making skills.

What you should expect in this role

Remote position supporting Medicaid rehabilitation and healthcare programs; candidates must be located within the United States while performing work.

Full-time temporary assignment expected to last 9-12 months, with potential for extension based on business needs.

Standard schedule: Monday-Friday, 8:00 AM-5:00 PM PT; flexibility required as needed.

• Collaborate with providers, clients, and multidisciplinary healthcare teams.
• Participate in peer reviews, case consultations, and clinical documentation reviews.
• Influence clinical policy, quality outcomes, and program effectiveness.

This is a pipeline requisition. Applications will be reviewed on an ongoing basis.

The pay range for this position is $176,900.00 - $252,700.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy,a 401(k) employer match, comprehensive health benefits , and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.