More jobs:
Internal Medicine Physician
Remote / Online - Candidates ideally in
New York, USA
Listed on 2026-03-10
New York, USA
Listing for:
Trusted Locum Staffing LLC.
Full Time, Part Time, Remote/Work from Home
position Listed on 2026-03-10
Job specializations:
-
Doctor/Physician
Medical Doctor, Healthcare Consultant
Job Description & How to Apply Below
We are seeking Physicians (MD/DO) to join our Utilization Management team in a 100% remote role. This position involves reviewing medical cases to determine medical necessity and appropriateness of care using evidence-based guidelines and health plan policies.
Position Details- Pay: $175 per hour
- Location: Fully Remote
- Schedule: Full-time (40 hrs/week) or Part-time (20 hrs/week) options available
- Weekend availability may be offered
- Perform prior authorization, concurrent, and retrospective reviews
- Apply Inter Qual, MCG, and health plan guidelines to determine medical necessity
- Participate in peer-to-peer discussions with providers when needed
- Collaborate with UM nurses and medical directors to support appropriate care decisions
- Ensure compliance with CMS, NCQA, and URAC standards
- MD or DO degree
- Board Certified
- Active unrestricted medical license (any state)
- Utilization Management experience within a health plan
- Experience with Medicare/Medicaid and commercial plans preferred
This is an excellent opportunity for physicians seeking remote work with flexible scheduling while applying clinical expertise in a utilization management setting.
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