Physician Reviewer – Utilization Management

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🌵 Arizona, Florida, +1 more states – Remote

🌵 Arizona – Remote 🐊 Florida – Remote 🌲 North Carolina – Remote

💵 $211.2k - $277.2k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

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Oscar

WebsiteLinkedInAll Job Openings

51 - 200 employees

🎯 Recruiter

🏢 Enterprise

💰 $140M Private Equity Round on 2020-12

Recruitment • Enterprise

Oscar is a world-class specialist STEM recruitment agency that provides industry-leading talent solutions. The company operates across six brands, connecting top talent with companies in various sectors including technology, construction, life sciences, and renewable energy. With offices across the globe, Oscar is recognized as a top-five company to work for and is committed to delivering excellence in staffing services.

📋 Description

• Determine the medical appropriateness of inpatient, outpatient, and pharmacy services by reviewing clinical information and applying evidence-based guidelines • Provide timely medical reviews that meet Oscar's stringent quality parameters • Provide clinical determinations based on evidence-based criteria and Oscar internal guidelines and policies, while utilizing clinical acumen • Clearly and accurately document all communication and decision-making in Oscar workflow tools • Use correct templates for documenting decisions during case review • Meet the appropriate turn-around times for clinical reviews • Conduct timely peer-to-peer discussions with treating providers to clarify clinical information and explain review outcome decisions • Compliance with all applicable laws and regulations

🎯 Requirements

• Board certification as an MD or DO • Licensed in one of these states: FL, NC, AZ OR possess an active Interstate Medical Licensure Compact (IMLC) • 6+ years of clinical practice

🏖️ Benefits

• Health insurance • 401(k) plan participation • Paid parental leave • Paid sick time • Paid time off • 11 paid holidays • Unlimited vacation • Annual performance bonuses