Physician Reviewer - Utilization Management

Oscar is seeking a Physician Reviewer to join its Utilization Management team, determining the medical appropriateness of inpatient, outpatient, and pharmacy services through clinical reviews and evidence-based guidelines. The role involves reporting to the Associate Medical Director, conducting peer-to-peer discussions with providers, and ensuring compliance with quality parameters and regulations. This remote position requires board certification, state licensure, and extensive clinical practice experience.