Multi-State Licensed Physician Reviewer

Job Summary

A company is looking for a 1099-PRN Physician for Utilization Review.

Key Responsibilities

• Evaluate Prior Authorization requests for treatments, medications, and other services
• Ensure reviews comply with ERISA/DOL requirements and state regulations
• Participate in Peer-to-Peer calls as needed during standard business hours

Required Qualifications, Training, and Education

• MD or DO degree required
• Board Certification in Family Medicine or Internal Medicine is mandatory
• Active, unrestricted medical license in specified states or a current Letter of Qualification from the IMLCC
• Proficient with computer systems and digital tools
• Ability to maintain a 95% or better quality in case completion