State Licensed Utilization Management Physician Reviewer
Company: VirtualVocations
Location: Vista
Posted on: May 23, 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 rationale according
to policies and standards
Utilize evidence-based criteria and clinical judgment to make
utilization management determinations
Collaborate with care teams to enhance efficient and effective
patient care delivery
Required Qualifications
At least one year of experience in Utilization Management for
Medicare and/or Medicaid
A current, unrestricted clinical license to practice medicine in
the U.S
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
Understanding of managed care and relevant healthcare practices
Keywords: VirtualVocations, Irvine , State Licensed Utilization Management Physician Reviewer, Healthcare , Vista, California
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