Utilization Management Physician Reviewer
Company: VirtualVocations
Location: Vista
Posted on: May 24, 2025
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Job Description:
A company is looking for a Utilization Management Physician
Reviewer.
Key Responsibilities
Review service requests and document decision rationales according
to policies and industry standards
Utilize evidence-based criteria and clinical reasoning for making
UM determinations
Collaborate with care teams to enhance patient care delivery and
maintain compliance with regulations
Required Qualifications
At least one year of experience in Utilization Management for
Medicare and/or Medicaid
A current, unrestricted medical license to practice in the U.S
Graduate of an accredited medical school with an M.D. or D.O.
degree
3-5 years of clinical practice experience in a primary care
setting
Strong understanding of managed care and relevant healthcare
practices
Keywords: VirtualVocations, Redlands , Utilization Management Physician Reviewer, Executive , Vista, California
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