Physician Reviewer - Utilization Management

ABOUT THE ROLE We're Oscar, a health insurance company built around a full stack technology platform and a relentless focus on serving our members. We're seeking a Physician Reviewer to join our Utilization Management team, where you'll play a critical role in determining the medical appropriateness of inpatient, outpatient, and pharmacy services. WHAT YOU'LL DO As a Physician Reviewer, you'll review clinical information and apply evidence-based guidelines to make timely medical determinations that meet Oscar's stringent quality parameters. Your responsibilities will include: - Providing clear and accurate documentation of all communication and decision-making in Oscar's workflow tools - Using correct templates for documenting decisions during case review - Meeting turn-around times for clinical reviews - Receiving and reviewing escalated reviews - Conducting timely peer-to-peer discussions with treating providers to clarify clinical information and explain review outcome decisions - Compliance with all applicable laws and regulations - Other duties as assigned WHAT YOU'LL NEED To be successful in this role, you'll need: - Board certification as an MD or DO - Licensure in one of the following states: FL, NC, AZ, or possession of an active Interstate Medical Licensure Compact (IMLC) - 6+ years of clinical practice WHY REMOTE 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. BENEFITS The base pay for this role is $211,200 - $277,200 per year, with the opportunity to earn annual performance bonuses. You'll also be eligible for employee 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 reimbursements.