Florida Licensed Family Medicine Reviewer

Job Summary

A company is looking for a 1099 Utilization Review for Family Medicine Physicians.

Key Responsibilities

• Evaluate medical records to determine the medical necessity and appropriateness of healthcare services
• Review documentation against evidence-based criteria such as InterQual and Medicare policies
• Ensure compliance with regulatory and health plan requirements during the review process

Required Qualifications, Training, and Education

• MD or DO, currently Board Certified in Family Medicine
• Minimum 5 years of direct clinical experience in Family Medicine, including residency
• Unrestricted medical license in Florida, Minnesota, Pennsylvania, Indiana, Oregon, or Texas, or a current "Letter of Qualification" from the IMLCC
• Willingness and availability for daytime peer-to-peer conversations
• Must be a U.S. Citizen or Green Card holder