Duties: Perform pre-authorization, concurrent, and post-service medical necessity reviews using evidence-based criteria (MCG, InterQual, CMS).
Render clear certification and non-certification determinations, including peer-to-peer and urgent case discussions with providers.
Serve as a clinical resource to UM staff and consult with physicians across specialties as needed.
Support provider education, assist the CMO, and participate in clinical criteria review and updates.
Ensure compliance with all utilization management, regulatory, and accreditation standards.
Requirements: MD/DO unrestricted Florida license, board certification preferred, 3 5 years of clinical experience.
Comp: 240K plus full benefits
Reference: PDmedsour-27-2/23/26-lp-afOccupational Medicine Physician in not specified at Unknown Company
This position is listed as full time and onsite.