Anesthesiology Physician - Charleston - The Provider Finder

    The Provider Finder
    The Provider Finder Charleston

    1 week ago

    $280,000 - $520,000 (USD) per year *
    Description
    Utilization Management Physician (UMP)
    Full-Time Remote Florida License Required

    We are seeking a

    Utilization Management Physician (UMP)

    for a full-time, remote opportunity with a well-established, multi-specialty healthcare organization in Florida.

    This role requires strong clinical judgment, critical thinking skills, and effective communication to support medical necessity determinations and utilization review processes.


    Key Responsibilities:
    Review pre-authorization requests, including initial and concurrent clinical review cases

    Conduct post-service clinical reviews, including claims and appeals

    Render determinations based on evidence-based medicine and nationally recognized criteria such as MCG, InterQual, and CMS guidelines

    Ensure compliance with regulatory standards for pre-authorization determinations

    Provide clear clinical rationale for non-certification decisions

    Participate in peer-to-peer discussions (telephonic or electronic) regarding cases under review

    Be available to address urgent cases with attending providers

    Assist with provider education related to treatment protocols and options

    Participate in committees as requested

    Collaborate with specialty physicians as needed

    Participate in quality review and interrater reliability processes


    Qualifications:
    MD, DO, or PhD from an accredited medical school

    Active, unrestricted Florida medical license

    Board certification in primary specialty preferred

    3-5 years of clinical experience

    Experience with managed care and health plan benefits

    Strong understanding of medical policy and application of clinical criteria

    Ability to evaluate complex cases and make sound determinations


    Compensation & Benefits:
    Competitive salary

    Bonus opportunity

    401(k) Tax Deferred Plan

    Comprehensive health benefits for provider and eligible dependents

    Group life and disability insurance

    Malpractice coverage

    Paid time off

    CME stipend

    Licenses, fees, and dues reimbursement

    Travel reimbursement

    Relocation assistance


    This is an excellent opportunity for physicians seeking a remote position with strong work-life balance while remaining clinically engaged in utilization management.

    Thank you for your time, and I look forward to connecting soon
    Manish Parashar
    Recruiter, The Provider Finder
    * This salary range is an estimation made by beBee
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