Licensed Physician Reviewer
Core
Primary physician reviewer for Utilization Management (UM) cases, covering assigned territories and coordinating care for patients.
Role type
Licensed Physician Reviewer (Utilization Management)
Builds
Delegated Utilization Management processes and patient care coordination
Domain
Healthcare / Utilization Management
Required skills
Medical licensure, Utilization Management expertise, Territory management, Health plan coordination, Process improvement
Responsibilities
Cover specified territories and establish 2-3 UM cases daily; attend health plan and local calls; participate in weekly PCP and SNF meetings; advise other physician reviewers; participate in Process and Quality improvement initiatives.
Sourced via workday · Listed on CareerPlan, which tracks 853,000+ jobs from 20+ sources.