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Licensed Physician Reviewer

jobgether

USFull-time
Posted
1 month ago
Source
Jobgether (lever)

Skills

CommunicationNext.js

Description

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Licensed Physician Reviewer based in United States. As a Licensed Physician Reviewer, you will serve as a primary physician reviewer for Utilization Management (UM) cases, helping ensure patients receive appropriate, coordinated, and medically necessary care. You will support delegated UM activities across multiple markets while collaborating closely with health plan teams, local clinical teams, and other physician reviewers. The role combines clinical judgment with care coordination, stakeholder communication, and process improvement. You will review cases, provide physician-level guidance, and contribute to consistent and effective utilization management practices. You will also participate in quality and process improvement initiatives as the delegated UM function continues to evolve. This is an opportunity to apply your clinical expertise in a collaborative environment focused on improving outcomes and the healthcare experience for older adults.

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