Oscar
More roles at OscarPhysician Reviewer - Utilization Management
Remote role where the employee must remain based in a particular country.
United States only
From the employer's advert: Work Location: This is a remote position, open to candidates who reside in the United States.
Employer listed it 7 days ago · Added 4 days ago
First listed 7 days ago and still open.
Salary
$219k to $287k per year
Location
United States only
Timezone
Not stated
Contract
Full-time
Experience
Entry
Category
Healthcare
Stated by the employer in the job description
What the advert says
Quoted word for word from the employer's advert. Where it says nothing, we say so.
- Working hours
Hours: 8am - 5pm in your local time zone
- Where you can work from
Work Location: This is a remote position, open to candidates who reside in the United States.
- Contract
Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and…
- Experience asked for
- Not mentioned in the advert
- Pay
Pay Transparency: The base pay for this role is: $219,000- $ 286,902 per year.
Remote flexibility
Work from home
This is a remote role, but the employee must be based in United States. It is work from home rather than work from anywhere.
What the employer says
- Source listing states candidate location: "Remote, Remote (Arizona)"
What Nomaders makes of it
- Residency required in United States
- Payroll and tax are likely handled in that country only
The quotes above are the employer's own words; the reading is ours. Always check the original listing and employment terms before working from another country.
About the role
Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team.
Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.
About the role:
You will determine the medical appropriateness of inpatient, outpatient, and pharmacy services by reviewing clinical information and applying evidence-based guidelines.
Hours: 8am - 5pm in your local time zone
Call rotation - 1 weekend every 16 weeks
You will report into the Associate Medical Director, Utilization Management.
Work Location: This is a remote position, open to candidates who reside in the United States. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote
Pay Transparency: The base pay for this role is: $219,000- $ 286,902 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation, and annual performance bonuses.
Responsibilities:
Provide medical reviews that meet Oscar's stringent quality parameters.
Provide clinical determinations based on evidence-based criteria and Oscar internal guidelines and policies, while utilizing clinical acumen.
Clearly and accurately document all communication and decision-making in Oscar workflow tools, ensuring a member could easily reference and understand your decision (Flesch-Kincaid grade level).
Use correct templates for documenting decisions during case review.
Meet the appropriate turn-around times for clinical reviews.
Receive and review escalated reviews.
Conduct timely peer-to-peer discussions with treating providers to clarify clinical information and to explain review outcome decisions, including feedback on alternate treatment based on medical necessity criteria and evidence-based research.
Compliance with all applicable laws and regulations
Other duties as assigned
Requirements:
Board certification as an MD or DO
Licensed in one of these states: FL, NC, AZ OR possess an active Interstate Medical Licensure Compact (IMLC).
6+ years of clinical practice
Bonus points:
Requirements
- ·Board certification as an MD or DO
- ·Licensed in one of these states: FL, NC, AZ OR possess an active Interstate Medical Licensure Compact (IMLC).
- ·6+ years of clinical practice
- ·Licensure in multiple Oscar states
Benefits
No benefits package published with this listing. Ask about it at first interview.
How to apply
- 1Check the flexibility label above, work from home, matches where you plan to live and work.
- 2Tailor your CV to the role at Oscar, mentioning your remote working experience.
- 3Apply directly on the employer's careers page using the button below. Nomaders never handles your application.
Found 5d ago. Last checked today. Always confirm the details on the original posting, salary and location can change after publication.
Listing sourced from Company boards.
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