Physician Reviewer Jobs
Physician Reviewer jobs are open across health insurance, managed care, utilization management, and workers' compensation, from entry-level to medical director roles, with specializations in utilization review, claims review, and quality assurance. Find a role that fits from the openings below and apply directly.
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Showing 5 of 33+ Physician Reviewer jobs
Grow Healthy
If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day.
Job Overview
The Physician Reviewer, Medical Management, provides a routine review of authorization requests from all lines of business using respective national/state health plans and nationally recognized guidelines where appropriate, to guide the processing of referrals. The Physician Reviewer approves authorizations per delegation responsibilities in the AltaMed Authorization Matrix and, where applicable, per their training and licensing restrictions. The Physician Reviewer , Medical Management process es d enials of authorizations using standard denial language noted from the above hierarchy of guidelines and posts recommendations in the authorization platform to inform the Medical Director workflow. Physician Reviewers of Medical Management review and ma ke recommendations on retro claims reviews for outpatient authorization, inpatient authorizations, and Emergency Room claims. Physician Reviewer , Medical Man agement may be involved in ad hoc projects and analysis of high-cost utilization areas, unmanaged care, inappropriate utilization , billing practices, and budgeting/finances reporting. The Physician Reviewer, Medical Management is responsible for identifying high-risk populations via provider/clinic referral, utilization management referral, disease registry reporting mechanisms, and patient self-referral, and will refer high-risk patients to appropriate case management programs . With the approval of the Medical Director of Pediatric Utiliz ation Management , Physician Reviewer , Medical Management provides oversight, guidance, and training sessions to UM nurse reviewers and other UM staff, where applicable. This position will provide case management to patients admitted to the hospital and those who may need to be enrolled in ambulatory case management. The Physician Reviewer , Medical Management works as part of an interdisciplinary care team participating in the coordination of care with social work and mental health counseling, psycho-social support services, in-home support, legal services, skilled nursing, home health, etc.
Minimum Requirements
MD/DO, Physician Training Program completed, Board Certified Preferred
Graduation from an accredited medical training program.
A minimum requirement of a valid BLS certification or higher, following the American Heart Association (AHA) or the American Red Cross guidelines.
Compensation
$248,922.64 - $311,153.30 annuallyCompensation Disclaimer
Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives.
Benefits & Career Development
- Medical, Dental and Vision insurance
- 403(b) Retirement savings plans with employer matching contributions
- Flexible Spending Accounts
- Commuter Flexible Spending
- Career Advancement & Development opportunities
- Paid Time Off & Holidays
- Paid CME Days
- Malpractice insurance and tail coverage
- Tuition Reimbursement Program
- Corporate Employee Discounts
- Employee Referral Bonus Program
- Pet Care Insurance
Job Advertisement & Application Compliance Statement
AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.
Grow Healthy
If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day.
Job Overview
The Physician Reviewer, Medical Management, provides a routine review of authorization requests from all lines of business using respective national/state health plans and nationally recognized guidelines where appropriate, to guide the processing of referrals. The Physician Reviewer approves authorizations per delegation responsibilities in the AltaMed Authorization Matrix and, where applicable, per their training and licensing restrictions. The Physician Reviewer , Medical Management process es d enials of authorizations using standard denial language noted from the above hierarchy of guidelines and posts recommendations in the authorization platform to inform the Medical Director workflow. Physician Reviewers of Medical Management review and ma ke recommendations on retro claims reviews for outpatient authorization, inpatient authorizations, and Emergency Room claims. Physician Reviewer , Medical Man agement may be involved in ad hoc projects and analysis of high-cost utilization areas, unmanaged care, inappropriate utilization , billing practices, and budgeting/finances reporting. The Physician Reviewer, Medical Management is responsible for identifying high-risk populations via provider/clinic referral, utilization management referral, disease registry reporting mechanisms, and patient self-referral, and will refer high-risk patients to appropriate case management programs . With the approval of the Medical Director of Pediatric Utiliz ation Management , Physician Reviewer , Medical Management provides oversight, guidance, and training sessions to UM nurse reviewers and other UM staff, where applicable. This position will provide case management to patients admitted to the hospital and those who may need to be enrolled in ambulatory case management. The Physician Reviewer , Medical Management works as part of an interdisciplinary care team participating in the coordination of care with social work and mental health counseling, psycho-social support services, in-home support, legal services, skilled nursing, home health, etc.
Minimum Requirements
MD/DO, Physician Training Program completed, Board Certified Preferred
Graduation from an accredited medical training program.
A minimum requirement of a valid BLS certification or higher, following the American Heart Association (AHA) or the American Red Cross guidelines.
Compensation
$248,922.64 - $311,153.30 annuallyCompensation Disclaimer
Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives.
Benefits & Career Development
- Medical, Dental and Vision insurance
- 403(b) Retirement savings plans with employer matching contributions
- Flexible Spending Accounts
- Commuter Flexible Spending
- Career Advancement & Development opportunities
- Paid Time Off & Holidays
- Paid CME Days
- Malpractice insurance and tail coverage
- Tuition Reimbursement Program
- Corporate Employee Discounts
- Employee Referral Bonus Program
- Pet Care Insurance
Job Advertisement & Application Compliance Statement
AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.
Physician Reviewer Jobs by Experience Level
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Find Physician Reviewer JobsPhysician Reviewer Job Market
Who's Hiring
Top Industries Hiring
- Insurance
- Non-Profit & Social Services
- Healthcare & Medical Services
What Employers Look For
The qualifications that appear most often in physician reviewer jobs.
- Active, unrestricted medical license in at least one U.S. state
- Board certification in a relevant clinical specialty such as internal medicine or orthopedics
- Minimum two to five years of direct patient care experience post-residency
- Working knowledge of InterQual or MCG medical necessity criteria
- Experience with ICD-10 coding and clinical documentation review
- Familiarity with utilization management processes and regulatory compliance standards
Tips for Your Physician Reviewer Job Search
Tailor your resume for non-clinical reviewers
Highlight your clinical specialty, years of direct patient care, and any experience with ICD-10 coding or medical necessity criteria. Reviewers with UM or UR background get screened in faster, so name those credentials explicitly rather than burying them in job duties.
Earn an InterQual or MCG certification first
Many physician reviewer postings list InterQual or MCG criteria knowledge as a requirement, not a preference. Completing a vendor training course before you apply signals readiness and shortens your ramp time, which hiring managers value in high-volume review environments.
Apply early to roles that fit
Migrate Mate lists physician reviewer openings from across the United States in one place, so you can find roles that match and apply directly to each listing.
Filter openings by your specialty credential
Payers often post separate openings for reviewers with specific board certifications such as internal medicine, psychiatry, or orthopedics. Search by your specialty rather than the generic title to surface roles where your clinical background directly matches the case volume the team reviews.
Prepare for a case simulation interview
Many hiring panels ask you to walk through a real or anonymized case and explain your medical necessity rationale aloud. Practice articulating your clinical reasoning against a specific criteria set, such as InterQual, so your answer follows the structure reviewers actually use on the job.
Negotiate your hours and on-call structure clearly
Physician reviewer roles vary widely in whether evening, weekend, or on-call coverage is expected. Ask directly about the rotation schedule and turn-around-time expectations before accepting an offer, since these details rarely appear in the job posting and materially affect workload.
Physician Reviewer Jobs: Frequently Asked Questions
Which companies are hiring the most physician reviewers?
The companies hiring the most physician reviewers right now include Dane Street, ChenMed, and Toney HealthCare Consulting, with the largest share of openings in Florida, California, and New York, based on current listings on Migrate Mate as of November 2026. Managed care organizations and third-party review vendors consistently maintain the highest volume of open roles.
How many physician reviewer jobs are remote?
About 96% of physician reviewer openings are fully remote or hybrid as of November 2026, making it one of the more flexible physician roles available. Utilization management and independent medical review positions are most likely to be fully remote, while peer-to-peer review roles tied to a specific health plan often require some on-site presence.
How do you become a physician reviewer?
You become a physician reviewer by completing medical school and residency, obtaining board certification in a clinical specialty, and gaining direct patient care experience. From there, you pursue roles in utilization management or independent review, learn the criteria sets employers use such as InterQual or MCG, and build familiarity with payer policies and medical necessity standards through on-the-job training or targeted coursework.
Can you get a physician reviewer job with little review experience?
Yes, you can get a physician reviewer job with limited formal review experience if your clinical background is strong and matches the case types the employer handles. Many payers hire physicians directly from clinical practice and train them on criteria application internally. Emphasizing your documentation habits, coding familiarity, and any peer review or quality committee work in your application improves your chances significantly.
What does the physician reviewer interview process look like?
The physician reviewer interview process typically includes an initial screening call with a recruiter, a clinical interview with a medical director or peer reviewer, and a case review exercise where you walk through your medical necessity reasoning aloud. Some employers add a compliance or credentialing review step before extending an offer. The entire process usually runs from a recruiter call through a final decision in two to four stages.
Where can I find and apply to physician reviewer jobs?
You can find and apply to physician reviewer jobs on Migrate Mate, which lists current openings from across the United States. Find roles that match your specialty and experience level, then apply directly to each listing. No steps beyond the application are needed to get your materials in front of the hiring team.
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