Physician Reviewer – Part Time

CareCentrix

Physician Reviewer conducting utilization reviews for medical necessity across various healthcare services for CareCentrix. Collaborating with providers and physicians to ensure evidence-based care decisions.

Posted 6/25/2026part-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $150 - $170 per hourWebsite

About the role

Key responsibilities & impact

Conduct medical necessity reviews for cases that may not meet established criteria and issue adverse determinations when appropriate
Evaluate requests across post-acute care services in alignment with clinical and regulatory standards
Meet or exceed Service Level Agreements (SLA) and performance guarantees required by health plan clients
Apply sound clinical judgment and maintain integrity in all determinations and interactions
Collaborate effectively with internal and external stakeholders, including providers and physicians
Perform other duties as assigned

Requirements

What you’ll need

MD or DO with an active, unrestricted medical license (in states aligned with CareCentrix client payer requirements)
Current and unexpired board certification in a relevant specialty
Minimum 3+ years of utilization management (UM) experience
Minimum 3+ years of clinical practice experience, including inpatient care
Experience using evidence-based clinical guidelines (e.g., Milliman/InterQual), as well as CMS and state-specific regulatory criteria, preferred

Benefits

Comp & perks

🌐 Worldwide ❌ Jobs You've Hidden ⭐️ Saved Jobs ✅ Applied Jobs ✉️ Email Alerts 👤 Account CareCentrix Website LinkedIn All Job Openings 1001 - 5000 employees Founded 1996 ⚕️ Healthcare Insurance 💊 Pharmaceuticals 💰 Private Equity Round on 2011-09 Healthcare Insurance
Healthcare
Pharmaceuticals CareCentrix is a healthcare company that simplifies care coordination and home benefit management, enabling health at home for members. By focusing on personalized care and utilizing their proprietary HomeBridge platform, they identify and engage members transitioning from hospital to home, ensuring timely delivery of appropriate services. CareCentrix's whole-person approach aims to improve outcomes, lower costs, and enhance both member and provider satisfaction through a high-quality provider network and data-driven analytics. Physician Reviewer – Part Time 🔥 26 minutes ago 🇺🇸 United States – Remote 💵 $150 - $170 / hour ⏱ Part Time 🟡 Mid-level 🟠 Senior 🦅 H1B Visa Sponsor Apply Now Find Hiring Managers Customize resume + cover letter Report problem ☆ Save ☑️ Mark as applied ❌ Hide 📋 Description
Conduct medical necessity reviews for cases that may not meet established criteria and issue adverse determinations when appropriate
Evaluate requests across post-acute care services in alignment with clinical and regulatory standards
Meet or exceed Service Level Agreements (SLA) and performance guarantees required by health plan clients
Apply sound clinical judgment and maintain integrity in all determinations and interactions
Collaborate effectively with internal and external stakeholders, including providers and physicians
Perform other duties as assigned 🎯 Requirements
MD or DO with an active, unrestricted medical license (in states aligned with CareCentrix client payer requirements)
Current and unexpired board certification in a relevant specialty
Minimum 3+ years of utilization management (UM) experience
Minimum 3+ years of clinical practice experience, including inpatient care
Experience using evidence-based clinical guidelines (e.g., Milliman/InterQual), as well as CMS and state-specific regulatory criteria, preferred Apply Now 📊 Check your resume score for this job Improve your chances of getting an interview by checking your resume score before you apply. Check Resume Score Similar Jobs Senior Meta Ads Specialist, Films 🔥 27 minutes ago Hire Digital 51 - 200 🎯 Recruiter ☁️ SaaS 🏢 Enterprise Website LinkedIn All Job Openings Senior Meta Ads Specialist managing paid ads focusing on Persian-Americans and U.S. film communities. Advise on strategies for creator brands and film studios with a focus on engagement. 🇺🇸 United States – Remote ⏱ Part Time 🟠 Senior Development Associate 🔥 28 minutes ago Young Americans for Liberty 11 - 50 🤝 Non-profit 🌍 Social Impact Website LinkedIn All Job Openings Development Associate managing major donor outreach and relationship-building in a remote setting. Focused on scheduling meetings, donor research, and direct donation solicitations. 🇺🇸 United States – Remote 💵 $1.4k / month ⏱ Part Time 🟢 Junior 🟡 Mid-level 🚫👨‍🎓 No degree required Registered Dietitian, Lifestyle & Longevity Nutrition, Telehealth 🔥 31 minutes ago Total Life 1 - 10 🧘 Wellness ⚕️ Healthcare Insurance 📡 Telecommunications Website LinkedIn All Job Openings Registered Dietitian providing personalized nutritional care plans for older adults via telehealth. Collaborating with care teams to support patients managing chronic conditions as part of a national telehealth platform. 🇺🇸 United States – Remote 💰 Seed Round on 2022-01 ⏱ Part Time 🟡 Mid-level 🟠 Senior Psychiatric Mental Health Nurse Practitioner – Telehealth 🔥 31 minutes ago Total Life 1 - 10 🧘 Wellness ⚕️ Healthcare Insurance 📡 Telecommunications Website LinkedIn All Job Openings Hiring PMHNPs to deliver telehealth psychiatric care to seniors. Flexible remote part-time contractor position focusing on patient care rather than administration. 🇺🇸 United States – Remote 💰 Seed Round on 2022-01 ⏱ Part Time 🟡 Mid-level 🟠 Senior Psychiatric Mental Health Nurse Practitioner, Telehealth 🔥 31 minutes ago Total Life 1 - 10 🧘 Wellness ⚕️ Healthcare Insurance 📡 Telecommunications Website LinkedIn All Job Openings Remote PMHNP or Psychiatrist delivering telehealth psychiatric evaluations to older adults. Collaborating on a new psychiatric care model for seniors at Total Life. 🇺🇸 United States – Remote 💰 Seed Round on 2022-01 ⏱ Part Time 🟡 Mid-level 🟠 Senior 🌐 Worldwide Built by Lior Neu-ner. I'd love to hear your feedback — Get in touch via DM or support@remoterocketship.com Search Search Jobs by country Search jobs by city Search jobs by job title Search entry-level jobs Search junior-level jobs Search senior-level jobs Search jobs by tech stack Search jobs by contract type Search remote internships Search remote part-time jobs Remote jobs Anywhere in the World Companies Hiring Anywhere in the World Companies Hiring Sales People Anywhere in the World Companies Hiring Software Engineers Anywhere in the World Resources Advice Tips for finding remote jobs Interview questions and answers Resume examples Cover letter examples Post a job Affiliates Privacy policy Terms of service Job board SEO course AI Apply Copilot OpenClaw job finder Jobs by Country Remote jobs anywhere in the world (Worldwide remote jobs) Remote jobs United States Remote jobs Australia Remote jobs Brazil Remote jobs Canada Remote jobs France Remote jobs Ireland Remote jobs Germany Remote jobs Netherlands Remote jobs Spain Remote jobs UK Popular Jobs Remote data analyst jobs Remote customer support jobs Remote executive assistant jobs Remote marketing jobs Remote product designer jobs Remote product manager jobs Remote project manager jobs Remote recruiter jobs Remote sales jobs Remote software engineer jobs Jobs by Type Remote full-time jobs Remote part-time jobs Remote contract jobs Remote internship jobs Remote entry-level jobs Remote jobs with no experience required Remote junior jobs (1-3 years of experience) Digital nomad jobs Remote jobs with no degree required Freelance remote jobs Temporary remote jobs Remote jobs hiring now Stay at home mom jobs

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Applicant Tracking System Keywords

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Hard Skills & Tools

utilization managementclinical practiceevidence-based clinical guidelinesMillimanInterQualregulatory criteriamedical necessity reviewsadverse determinationspost-acute care servicesclinical judgment

Soft Skills

collaborationcommunicationintegritystakeholder engagementclinical judgment

Certifications

MDDOboard certification