Physician Advisor – Peer-to-Peer Medical Reviewer

Job overview

The Physician Advisor – Peer-to-Peer Medical Reviewer role is fully remote, with candidates required to work Eastern Time business hours; the listing identifies Saint Paul, MN. Compensation is not specified. The role supports utilization management through clinical discussions with treating providers and evidence-based review.

What you'll do

• Conduct scheduled and ad hoc peer-to-peer discussions
• review clinical documentation, utilization reviews, criteria, and determination rationale
• evaluate medical necessity and level of care
• apply CMS requirements, health plan policies, and approved clinical criteria
• document discussions and outcomes
• complete reviews within required turnaround times
• escalate complex cases and communicate recurring trends to utilization management leadership.

What we're looking for

Skills & competencies

physician advisor

peer-to-peer review

medical necessity

utilization management

fully remote

eastern time hours

md or do

u.s. medical license

board certified

cms medicare advantage

part-time hours

Work arrangement

• Weekend coverage required

Why this role

Requires an MD or DO, a current unrestricted U.S. medical license, and board certification in an appropriate specialty. Part-time hours are stated; Eastern Time business-hour availability is required.

About the employer

Impresiv Health is hiring for this role. Industry: Administrative Management and General Management Consulting Services. Sector: 54.