State Licensed Utilization Management Physician Reviewer
Company: VirtualVocations
Location: Vista
Posted on: May 7, 2025
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Job Description:
A company is looking for a Utilization Management Physician
Reviewer.
Key Responsibilities
Review service requests and document rationale for decisions in
accordance with policies and industry standards
Utilize evidence-based criteria and clinical reasoning to make
utilization management determinations
Collaborate with care teams to ensure efficient and effective
patient care delivery
Required Qualifications
At least one year of experience in Utilization Management for
Medicare and/or Medicaid
A current, clinical, unrestricted license to practice medicine in
the United States
Graduate of an accredited medical school with an M.D. or D.O.
degree
3-5 years of clinical practice in a primary care setting
Deep understanding of managed care and related processes
Keywords: VirtualVocations, Covina , State Licensed Utilization Management Physician Reviewer, Executive , Vista, California
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Click
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