Utilization Management Physician needed in Daytona Beach, FL (Remote)

HealthPlus Staffing • Daytona Beach, FL

2d • $240,000 • Remote

About The Position

Seeking an experienced Utilization Management Physician to perform medical necessity reviews, peer-to-peer discussions, and clinical determinations using evidence-based criteria.

Requirements

• 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

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

Benefits

• Bonus opportunity
• 401(k)
• Health benefits
• Malpractice coverage
• PTO + CME
• Licenses, fees, travel, and relocation reimbursed

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Ph.D. or professional degree