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 27+ Physician Reviewer jobs
Job Description:
Select Health is a not-for-profit community health plan serving more than 1 million members in the Intermountain West. Select Health’s line of businesses (LOB) includes Medicare, Medicaid, FEHB, Marketplace Qualified Health Plans and fully funded and self-funded Commercial plans. This position is responsible for providing physician peer review and clinical direction for Select Health including utilization management, case management, appeals, criteria and policy development and other projects as needed. This position is responsible for working with all the departments of Select Health, but primarily Utilization Management, Benefits Determination, Quality Improvement, Behavioral Health, Pharmacy Services, other Select Health Departments, and other Intermountain Health division as needed to implement policies and programs for the Office of the Medical Director to manage the provider panel and to maintain high customer satisfaction.Essential Functions
- Coverage & Benefits determinations: Act as the first level of reviews and appeals for panel providers or members' concerns regarding coverage/benefits issues or quality of care.
- Utilization Management: Assist in the development and review of Utilization Management screening criteria & policies used in the preauthorization process. Participate in the yearly guideline review process. Participate in ongoing evaluation of the UM process.
- Participate in a physician specialty panel to assist in peer review of cases and specified turnaround times by accreditation or licensing bodies.
- Education: Provide clinical education to members of the UM/CM and HCS staff as necessary to perform their function.
- Preauthorization and appeals: Review preauthorization requests which fail to pass criteria as applied by staff and document those utilization and case management decisions appropriately in the care management system.
- Committees: Represent Select Health on committees as assigned by the Medical Director.
- Delivery Improvement: Serve as a resource for the Select Health Medical Director in recommending ways to improve health services delivery and reduce medical expenses without compromising quality of care. Constantly stress and strive for cost-effectiveness on the part of physicians and ancillary health care providers.
- Certification Requirements: Assist and support Health Care Services departments as needed in maintaining NCQA, HEDIS, and CAHPS certification, and other contractual requirements such as Medicare, Medicaid, CHIP, exchange plans and FEHB compliance.
- Medical Policy: In cooperation with Medical Director, writes and updates medical policies.
- Interacts with the delivery system including clinical programs, individual physicians and clinics to align care process models and clinical practice to evidence based standards.
Skills
- Leadership
- Performance Metrics
- Results-Oriented
- Communication
- Problem Solving
- Taking Initiative
- Analytical Thinking
- Accountability
- Collaboration
- Professional Etiquette
Minimum Qualifications
- Medical Doctor or Doctor of Osteopathic Medicine degree with Board Certification in specialty. Degree must be obtained through an accredited institution. Education is verified.
- Requires current MD or DO licensure within the State of Utah, Idaho, Nevada or Colorado
- Five years of experience in clinical practice.
- Experience in a role requiring effective verbal, written, and interpersonal communication skills.
Preferred Qualifications
- Training in clinical quality improvement.
- Prior experience with Intermountain Health.
- Experience working in an integrated healthcare system.
- Knowledge of managed care products and processes as well as the impact of managed care on the market and cost of health care.
- Knowledge of the NCQA accreditation standards and process.
- Understanding of health care delivery system as it relates to government programs and agencies
Physical Requirements
- Interact with others requiring employee to verbally communicate as well as hear and understand spoken information.
- Operate computers, telephones, office equipment, and manipulate paper requiring the ability to move fingers and hands.
- See and read computer monitors and documents.
Location:
SelectHealth - MurrayWork City:
MurrayWork State:
UtahScheduled Weekly Hours:
20The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$7.25 - $999.99We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.
Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.
All positions subject to close without notice.
Job Description:
Select Health is a not-for-profit community health plan serving more than 1 million members in the Intermountain West. Select Health’s line of businesses (LOB) includes Medicare, Medicaid, FEHB, Marketplace Qualified Health Plans and fully funded and self-funded Commercial plans. This position is responsible for providing physician peer review and clinical direction for Select Health including utilization management, case management, appeals, criteria and policy development and other projects as needed. This position is responsible for working with all the departments of Select Health, but primarily Utilization Management, Benefits Determination, Quality Improvement, Behavioral Health, Pharmacy Services, other Select Health Departments, and other Intermountain Health division as needed to implement policies and programs for the Office of the Medical Director to manage the provider panel and to maintain high customer satisfaction.Essential Functions
- Coverage & Benefits determinations: Act as the first level of reviews and appeals for panel providers or members' concerns regarding coverage/benefits issues or quality of care.
- Utilization Management: Assist in the development and review of Utilization Management screening criteria & policies used in the preauthorization process. Participate in the yearly guideline review process. Participate in ongoing evaluation of the UM process.
- Participate in a physician specialty panel to assist in peer review of cases and specified turnaround times by accreditation or licensing bodies.
- Education: Provide clinical education to members of the UM/CM and HCS staff as necessary to perform their function.
- Preauthorization and appeals: Review preauthorization requests which fail to pass criteria as applied by staff and document those utilization and case management decisions appropriately in the care management system.
- Committees: Represent Select Health on committees as assigned by the Medical Director.
- Delivery Improvement: Serve as a resource for the Select Health Medical Director in recommending ways to improve health services delivery and reduce medical expenses without compromising quality of care. Constantly stress and strive for cost-effectiveness on the part of physicians and ancillary health care providers.
- Certification Requirements: Assist and support Health Care Services departments as needed in maintaining NCQA, HEDIS, and CAHPS certification, and other contractual requirements such as Medicare, Medicaid, CHIP, exchange plans and FEHB compliance.
- Medical Policy: In cooperation with Medical Director, writes and updates medical policies.
- Interacts with the delivery system including clinical programs, individual physicians and clinics to align care process models and clinical practice to evidence based standards.
Skills
- Leadership
- Performance Metrics
- Results-Oriented
- Communication
- Problem Solving
- Taking Initiative
- Analytical Thinking
- Accountability
- Collaboration
- Professional Etiquette
Minimum Qualifications
- Medical Doctor or Doctor of Osteopathic Medicine degree with Board Certification in specialty. Degree must be obtained through an accredited institution. Education is verified.
- Requires current MD or DO licensure within the State of Utah, Idaho, Nevada or Colorado
- Five years of experience in clinical practice.
- Experience in a role requiring effective verbal, written, and interpersonal communication skills.
Preferred Qualifications
- Training in clinical quality improvement.
- Prior experience with Intermountain Health.
- Experience working in an integrated healthcare system.
- Knowledge of managed care products and processes as well as the impact of managed care on the market and cost of health care.
- Knowledge of the NCQA accreditation standards and process.
- Understanding of health care delivery system as it relates to government programs and agencies
Physical Requirements
- Interact with others requiring employee to verbally communicate as well as hear and understand spoken information.
- Operate computers, telephones, office equipment, and manipulate paper requiring the ability to move fingers and hands.
- See and read computer monitors and documents.
Location:
SelectHealth - MurrayWork City:
MurrayWork State:
UtahScheduled Weekly Hours:
20The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$7.25 - $999.99We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.
Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.
All positions subject to close without notice.
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, Michigan Peer Review Organization, and ChenMed, with the largest share of openings in New York, Florida, and California, based on current listings on Migrate Mate as of September 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 September 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 27 Physician Reviewer Jobs
Find roles that match your experience and apply in just a few clicks.
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