Utilization Management Physician needed in Daytona Beach, FL (Remote)

HealthPlus Staffing; Daytona Beach (FL); Hybrid; USD 216,000 - 264,000; Full time

Benefits offered by this job

Bonus opportunity

401(k)

Health benefits

Malpractice coverage

PTO + CME

Licenses, fees, travel reimbursement

Job summary

A leading healthcare staffing firm is seeking a Utilization Management Physician for a remote position based in Florida. The ideal candidate will have an MD or DO with an active Florida license and at least 3 years of utilization management experience. Responsibilities include performing medical necessity reviews and conducting peer-to-peer discussions. The role comes with competitive compensation, including a $240,000 base salary plus bonuses and a comprehensive benefits package.

Qualifications

• We require an MD or DO with an active, unrestricted Florida license.
• Minimum of 3+ years of UM Physician experience.
• 3–7 years of clinical experience is mandatory.

Responsibilities

• Review authorizations, claims, and appeals.
• Make medical necessity determinations using MCG/InterQual/CMS criteria.
• Conduct peer-to-peer reviews and support UM staff.
• Participate in provider education as needed.

Skills

Medical necessity reviews

Peer-to-peer reviews

Managed care experience

Clinical determinations

Strong communication skills

Education

MD or DO with active Florida license

Job description

Utilization Management Physician (UMP)

Remote | Full-Time | Florida

Compensation: $240,000 base + bonus
Schedule: 40 hours/week
Work Model: Remote (on-site meetings in Daytona Beach, FL)

Overview

Seeking an experienced Utilization Management Physician to perform medical necessity reviews, peer-to-peer discussions, and clinical determinations using evidence-based criteria.

Responsibilities

• Review pre-auths, concurrent reviews, claims, and appeals
• Make medical necessity determinations using MCG/InterQual/CMS criteria
• Conduct peer-to-peer reviews and support UM staff
• Participate in committees and provider education as needed

Requirements

• MD or DO with active, unrestricted Florida license
• 3+ years UM Physician experience
• 3–7 years clinical experience
• Managed care experience required
• Available via phone, email, and Teams

Benefits

• Bonus opportunity
• 401(k)
• Health benefits
• Malpractice coverage
• PTO + CME
• Licenses, fees, travel, and relocation reimbursed

About Us

HealthPlus Staffing is National Leader in the Healthcare Staffing Industry. We partner up with top facilities nationwide with the focus of finding them highly qualified candidates.

Our Promise

• We will put you in front of the decision makers.
• We will provide feedback on your application.
• We will work on your behalf to obtain as much info as you need to make a well-informed decision.

If interested in this position, please submit an application or call us at 561-291-7787 to speak with one of our highly experienced consultants. We look forward to finding your next position!

The HealthPlus Team.