Top 65 Physician reviewer (part time) Jobs

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Physician Reviewer (Part Time)

CareCentrix -
Remote

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Job Details

Part-time
$150 - $170 an hour

Qualifications

Direct patient care
Inpatient experience
BC/BE
Utilization management
Resource utilization in healthcare
Medical License

Full Job Description

Overview:

As a Permanent Part-Time Physician Reviewer, you will conduct utilization reviews to determine medical necessity across our different lines of business, including Post-Acute Care, Home Health, Durable Medical Equipment (DME), Home Infusion Therapy, Sleep services.

In this role, you will collaborate, as needed, with internal staff, providers, and ordering physicians to support appropriate, evidence-based care decisions.

Position Details:

Title: Physician Reviewer (Part-Time, Permanent)
Pay: $150 to $170 per hour
Hours: 25 hours per week
Schedule: Consistent weekday schedule, between 8:00 a.m. and 6:00 p.m. EST, with flexibility to work additional hours as needed to meet business demands (including evenings, weekends, and holidays)

Responsibilities:

Conduct medical necessity reviews for cases that may not meet established criteria and issue adverse determinations when appropriate
Evaluate requests across post-acute care services in alignment with clinical and regulatory standards
Meet or exceed Service Level Agreements (SLA) and performance guarantees required by health plan clients
Apply sound clinical judgment and maintain integrity in all determinations and interactions
Collaborate effectively with internal and external stakeholders, including providers and physicians
Perform other duties as assigned

Qualifications:

MD or DO with an active, unrestricted medical license (in states aligned with CareCentrix client payer requirements)
Current and unexpired board certification in a relevant specialty
Minimum 3+ years of utilization management (UM) experience
Minimum 3+ years of clinical practice experience, including inpatient care
Experience using evidence-based clinical guidelines (e.g., Milliman/InterQual), as well as CMS and state-specific regulatory criteria, preferred

CareCentrix maintains a drug-free workplace

We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law.

CareCentrix accepts applications on an ongoing basis until a candidate is identified.

#IDCC

Apply Now

Refine Your Search

physician reviewer (part time) jobs

Physician Reviewer (Part Time)

Behavioral Health Physician Reviewer

Medical Consultant Reviewer - Internist PRN or Part-Time

Medical Director -- Part Time Contracted

Physician Reviewer Internal Medicine-Field Medical Director, Radiology (Part Time)

Physician Student Support Auditor

Part-time Pharmacy Technician (Remote)

RN Oasis Reviewer - Home Health Care - Part Time (4 days per week!)

IDR Nurse Reviewer

INDEPENDENT REVIEW NURSE

Psychiatrist Physician Reviewer - PRN - Remote (Within Illinois)

Appeals Coordinator, Geisinger Health Plan (eastern standard time zone resident)

Part Time Medical Director ( OBGYN /Based in MS)

(Part-Time) Nurse Case Reviewer / Legal Nurse | Orthopaedics / Neurosurgery | Onsite

RN - Registered Nurse - Clinical Documentation Improvement Educator

Utilization Review Specialist

Medical Director

Clinical Documentation Specialist, First Reviewer (H)

Pharmacy Technician - Managed Care

(Temporary) Clinical Research Coordinator Certificate Trainee - WV Clinical & Translational Science Institute

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