SCAN Health Plan in California seeks a temporary Medicare Advantage UM Physician to perform physician-level medical necessity reviews for prior authorizations and ongoing utilization management. The role ensures timely, evidence-based determinations and collaborates with RN reviewers and leadership.
You will conduct peer-to-peer discussions, support appeals, and maintain regulatory alignment with NCQA/URAC requirements while guiding a high-volume review team.
#J-18808-LjbffrRemote Medicare Advantage UM Physician in workfromhome at Unknown Company
This position is listed as full time and onsite.