Utilization Management Physician needed in Daytona Beach, FL (Remote)
$240kHealthPlus Staffing
Utilization Management Physician (UMP) Remote | Full-Time | Florida Compensation: $240,000 base + bonus
Schedule: 40 hours/week
Work Model: Remote (on-site meetings in Daytona Beach, FL ) Overview
Seeking an experienced Utilization Management Physician to perform medical necessity reviews, peer-to-peer discussions, and clinical determinations using evidence-based criteria. Responsibilities
Schedule: 40 hours/week
Work Model: Remote (on-site meetings in Daytona Beach, FL ) Overview
Seeking an experienced Utilization Management Physician to perform medical necessity reviews, peer-to-peer discussions, and clinical determinations using evidence-based criteria. Responsibilities
- Review pre-auths, concurrent reviews, claims, and appeals
- Make medical necessity determinations using MCG/InterQual/CMS criteria
- Conduct peer-to-peer reviews and support UM staff
- Participate in committees and provider education as needed
- MD or DO with active, unrestricted Florida license
- 3+ years UM Physician experience
- 3-7 years clinical experience
- Managed care experience required
- Available via phone, email, and Teams
- Bonus opportunity
- 401(k)
- Health benefits
- Malpractice coverage
- PTO + CME
- Licenses, fees, travel, and relocation reimbursed
- We will put you in front of the decision makers.
- We will provide feedback on your application.
- We will work on your behalf to obtain as much info as you need to make a well-informed decision.
Vacancy posted 4 days ago
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