Physician Utilization Review

Job Summary

A company is looking for an Associate Medical Director for Utilization Review Work for Physicians, remote and full-time.

Key Responsibilities

• Leverage clinical expertise to review medical records and make evidence-based determinations on service requests
• Conduct peer-to-peer phone calls with external providers to gather clinical information and discuss case determinations
• Ensure compliance with national guidelines, CMS regulations, and clinical best practices in all decision-making processes

Required Qualifications

• MD or DO degree with current board certification in Family Medicine or Internal Medicine
• 5 years of recent direct patient care experience, including 3 years in an inpatient hospital setting, preferably with ICU experience
• Strong computer literacy and adeptness with technology
• Willingness to obtain up to 20 additional state licenses, with costs covered by the company
• Clean background without prior licensure issues or pending malpractice