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 8+ Physician Reviewer jobs
Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.
About The Role
You will determine the medical appropriateness of inpatient, outpatient, and pharmacy services by reviewing clinical information and applying evidence-based guidelines.
Hours: 8am - 5pm in your local time zone
Call rotation - 1 weekend every 16 weeks
You will report into the Associate Medical Director, Utilization Management.
Work Location: 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.
Pay Transparency: The base pay for this role is: $211,200 - $277,200 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation, and annual performance bonuses.
Responsibilities
- Provide timely medical reviews that meet Oscar's stringent quality parameters.
- Provide clinical determinations based on evidence-based criteria and Oscar internal guidelines and policies, while utilizing clinical acumen.
- Clearly and accurately document all communication and decision-making in Oscar workflow tools, ensuring a member could easily reference and understand your decision (Flesch-Kincaid grade level).
- Use correct templates for documenting decisions during case review.
- Meet the appropriate turn-around times for clinical reviews.
- Receive and review escalated reviews.
- Conduct timely peer-to-peer discussions with treating providers to clarify clinical information and to explain review outcome decisions, including feedback on alternate treatment based on medical necessity criteria and evidence-based research.
- Compliance with all applicable laws and regulations
- Other duties as assigned
Requirements
- Board certification as an MD or DO
- Licensed in one of these states: FL, NC, AZ OR possess an active Interstate Medical Licensure Compact (IMLC).
- 6+ years of clinical practice
Bonus Points
- Licensure in multiple Oscar states
- 1+ years of utilization review experience in a managed care plan (health care industry)
- BC in Cardiology, Radiation/Oncology, or Neurology
- Experience with care management within the health insurance industry.
- Willing and able to obtain additional state licensure as needed, with Oscar's support
This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.
At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.
Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for 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.
Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.
Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.
California Residents: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Privacy Policy.
Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.
About The Role
You will determine the medical appropriateness of inpatient, outpatient, and pharmacy services by reviewing clinical information and applying evidence-based guidelines.
Hours: 8am - 5pm in your local time zone
Call rotation - 1 weekend every 16 weeks
You will report into the Associate Medical Director, Utilization Management.
Work Location: 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.
Pay Transparency: The base pay for this role is: $211,200 - $277,200 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation, and annual performance bonuses.
Responsibilities
- Provide timely medical reviews that meet Oscar's stringent quality parameters.
- Provide clinical determinations based on evidence-based criteria and Oscar internal guidelines and policies, while utilizing clinical acumen.
- Clearly and accurately document all communication and decision-making in Oscar workflow tools, ensuring a member could easily reference and understand your decision (Flesch-Kincaid grade level).
- Use correct templates for documenting decisions during case review.
- Meet the appropriate turn-around times for clinical reviews.
- Receive and review escalated reviews.
- Conduct timely peer-to-peer discussions with treating providers to clarify clinical information and to explain review outcome decisions, including feedback on alternate treatment based on medical necessity criteria and evidence-based research.
- Compliance with all applicable laws and regulations
- Other duties as assigned
Requirements
- Board certification as an MD or DO
- Licensed in one of these states: FL, NC, AZ OR possess an active Interstate Medical Licensure Compact (IMLC).
- 6+ years of clinical practice
Bonus Points
- Licensure in multiple Oscar states
- 1+ years of utilization review experience in a managed care plan (health care industry)
- BC in Cardiology, Radiation/Oncology, or Neurology
- Experience with care management within the health insurance industry.
- Willing and able to obtain additional state licensure as needed, with Oscar's support
This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.
At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.
Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for 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.
Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.
Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.
California Residents: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Privacy Policy.
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Find Physician Reviewer JobsPhysician Reviewer Job Market
A snapshot from current openings nationwide, updated as new roles post.
Who's Hiring
- CareCentrix3
- North East Medical Services2
- Oscar Health2
- Oscar Management Corporation1
Top Industries Hiring
- Healthcare & Medical Services5
- Non-Profit & Social Services2
- Insurance1
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
How many physician reviewer jobs are remote?
About 63% of physician reviewer openings are fully remote or hybrid as of June 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.
See All Physician Reviewer Jobs
Jump back to the full list of openings and apply to any physician reviewer role that fits.
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