Fully Remote UM Physician Reviewer Job at Insight Global, United States

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  • Insight Global
  • United States

Job Description

Position: Remote UM Physician Reviewer Location: FULLY REMOTE Working Hours: 8am-5pm their local time Salary: $270k--$283K Interview Process: 1 & Done Must Haves: Board certification as an MD or DO…FL license highly preferred 5-6+ years of clinical practice 1+ years of utilization review experience in a managed care plan (health care industry) Plusses: Licensed in FL or NC and/or active Interstate Medical Licensure Compact (IMLCC) or eligible to apply for IMLCC. D2D: Insight Global is hiring a fully remote Physician Reviewers for a leading health insurance company. The Physician Reviewer will review requests for care before, during, and after treatment to confirm they follow medical guidelines and company policies. This includes checking different types of services like hospital stays, rehab care, medical equipment, and outpatient treatments. They document their decisions clearly so members can easily understand them, and they use the right templates to keep everything consistent. Physician Reviewers also talk directly with doctors when needed to explain decisions or suggest alternative treatments based on medical evidence. They work quickly to meet deadlines, follow all laws and regulations, and handle other related tasks as needed. This is a remote position that requires strong attention to detail, clear communication, and the ability to make informed decisions quickly.

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