Determine medical appropriateness for inpatient, outpatient, and pharmacy services.
Lead and oversee physicians to meet quality standards.
Document decisions in Oscar workflow tools using templates.
Collaborate with Utilization Management Operations on key projects.
Ensure turnaround times for clinical reviews are met.
Remote role with travel; licensed in Florida, Arizona, or North Carolina, or IMLC.

🎯 Requirements

MD or DO with current unrestricted license.
3+ years of clinical practice.
2+ years utilization review in a managed care plan.

🎁 Benefits

Medical, dental, and vision benefits.
401(k) with immediate vesting.
18 PTO days per year.
Sick time, floating holidays and CME days.
Paid holidays.

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