Medical Reviewer; Radiologist; Remote CA

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Date:
Aug 22, 2026

Location:

West Sacramento, CA, US,  Any city, CA, US, 99999

Work Mode:
Virtual (Exception only)

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards.

You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.

Gainwell Technologies is seeking a Medical Reviewer (Radiologist) to provide physician-level radiology expertise supporting Medical Review Services for California healthcare programs. In this role, you will review radiology-related claims, Treatment Authorization Requests (TARs), medical records, and supporting clinical documentation to help ensure services meet applicable medical necessity, coverage, and program requirements.

• Review radiology-related claims, Treatment Authorization Requests (TARs), medical records, and supporting clinical documentation.
• Evaluate imaging and radiology services based on applicable medical policies, coverage requirements, and clinical standards.
• Provide physician-level medical review and clinical expertise for complex radiology cases.
• Support medical necessity and appropriateness determinations for requested or billed radiology services.
• Document review findings, decisions, and supporting clinical rationale clearly and accurately.
• Refer or collaborate on cases requiring additional clinical expertise when appropriate.
• Collaborate with physicians, nurses, other clinical specialists, operations teams, and business partners.
• Maintain knowledge of applicable radiology standards, medical policies, coverage requirements, and regulatory guidelines.
• Meet established quality, accuracy, productivity, and turnaround-time expectations.

• Minimum of three (3) years of experience as a Radiologist in a private, academic, or government setting.
• Current, non-expired physician license from the State of California, in good standing.
• Must not be under suspension from Medicare, Medicaid, or practice in California.
• Must not have been previously sanctioned for fraud or abuse.
• Strong oral and written communication skills.
• Strong clinical judgment and ability to interpret complex radiology-related medical records and supporting documentation.

• Full-time position.
• Remote work environment.
• Monday through Friday work schedule.
• Work primarily from your home office while supporting Medical Review Services for California healthcare programs.
• Spend the majority of your day reviewing radiology-related medical records, claims, authorization requests, imaging documentation, and supporting clinical information.
• Work independently while collaborating with physicians, nurses, other clinical specialists, operations teams, and business partners.
• Navigate multiple computer systems and applications to complete reviews, document findings, and support timely determinations.
• Maintain all professional licenses, certifications, and credentials required for the position in active, unrestricted, and good-standing status.
• Maintain knowledge of applicable medical policies, coverage requirements, radiology standards, and regulatory guidelines.
• Meet established quality, accuracy, productivity, and turnaround-time expectations.
• Receive ongoing training and support related to program requirements, systems, policies, and medical review processes.

This position is being posted for pipeline purposes, and we welcome applications on an ongoing basis.

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The pay range for this position is $150,000 - $175,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work ’ll have…