About the Role

$211K-$277K. Remote. 8-5 local time. Weekend call 1:16. No nights. Steady schedule.

Work-Life Balance Factors

No night shifts Remote/telehealth

⚠️ 24/7 coverage

Key Responsibilities

Requirements</h3><ul class="list-disc list-inside space-y-1.5 ml-4 mb-4"> <li>Board certification as an MD or DO</li> <li>Licensed in FL or NC and/or active Interstate Medical Licensure Compact (IMLCC) or eligible to apply for IMLCC.</li> <li>an experience made whole by our unique backgrounds and perspectives.</li> <li>set forth above, are determined by factors including your relevant skills, education, and experience. Full</li> </ul> <h3 class="text-lg font-bold text-slate-900 mt-6 mb-3">Benefits & Compensation</h3><p class="mb-4 text-slate-700">-</p> <h3 class="text-lg font-bold text-slate-900 mt-6 mb-3">Benefits & Compensation</h3> <ul class="list-disc list-inside space-y-1.5 ml-4 my-4"> <li class="text-slate-700">$ 277,200 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation, and annual performance bonuses.</li> <li class="text-slate-700">1+ years of utilization review experience in a managed care plan (health care industry)</li> <li class="text-slate-700">Bonus points:</li> <li class="text-slate-700">Experience with care management within the health insurance industry.</li> <li class="text-slate-700">This is an authentic Oscar Health job opportunity. Learn more</li> </ul> <h3 class="text-lg font-bold text-slate-900 mt-6 mb-3">Work Schedule</h3><p class="mb-4 text-slate-700">-</p> <h3 class="text-lg font-bold text-slate-900 mt-6 mb-3">Work Schedule</h3> <ul class="list-disc list-inside space-y-1.5 ml-4 my-4"> <li class="text-slate-700">Call rotation</li> <li class="text-slate-700">1 weekend every 16 weeks</li> </ul></div></div></div></div><div class="space-y-4 sm:space-y-6"><div class="sticky top-24 space-y-4"><div class="bg-white rounded-xl border border-slate-200 overflow-hidden"><div class="px-5 sm:px-6 pb-5 sm:pb-6 pt-5 sm:pt-6"><h4 class="text-sm font-semibold text-slate-700 mb-2.5">Benefits & Perks</h4><div class="grid grid-cols-1 sm:grid-cols-2 gap-1.5"><div class="flex items-start gap-2 text-sm text-slate-600"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-circle-check-big w-3.5 h-3.5 text-emerald-500 flex-shrink-0 mt-0.5" aria-hidden="true"><path d="M21.801 10A10 10 0 1 1 17 3.335"></path><path d="m9 11 3 3L22 4"></path></svg><span class="leading-snug">Medical Insurance</span></div><div class="flex items-start gap-2 text-sm text-slate-600"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-circle-check-big w-3.5 h-3.5 text-emerald-500 flex-shrink-0 mt-0.5" aria-hidden="true"><path d="M21.801 10A10 10 0 1 1 17 3.335"></path><path d="m9 11 3 3L22 4"></path></svg><span class="leading-snug">Dental Insurance</span></div><div class="flex items-start gap-2 text-sm text-slate-600"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-circle-check-big w-3.5 h-3.5 text-emerald-500 flex-shrink-0 mt-0.5" aria-hidden="true"><path d="M21.801 10A10 10 0 1 1 17 3.335"></path><path d="m9 11 3 3L22 4"></path></svg><span class="leading-snug">Vision Insurance</span></div><div class="flex items-start gap-2 text-sm text-slate-600"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-circle-check-big w-3.5 h-3.5 text-emerald-500 flex-shrink-0 mt-0.5" aria-hidden="true"><path d="M21.801 10A10 10 0 1 1 17 3.335"></path><path d="m9 11 3 3L22 4"></path></svg><span class="leading-snug">Paid Holidays (11)</span></div><div class="flex items-start gap-2 text-sm text-slate-600"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-circle-check-big w-3.5 h-3.5 text-emerald-500 flex-shrink-0 mt-0.5" aria-hidden="true"><path d="M21.801 10A10 10 0 1 1 17 3.335"></path><path d="m9 11 3 3L22 4"></path></svg><span class="leading-snug">Paid Sick Time</span></div><div class="flex items-start gap-2 text-sm text-slate-600"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-circle-check-big w-3.5 h-3.5 text-emerald-500 flex-shrink-0 mt-0.5" aria-hidden="true"><path d="M21.801 10A10 10 0 1 1 17 3.335"></path><path d="m9 11 3 3L22 4"></path></svg><span class="leading-snug">Paid Parental Leave</span></div><div class="flex items-start gap-2 text-sm text-slate-600"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-circle-check-big w-3.5 h-3.5 text-emerald-500 flex-shrink-0 mt-0.5" aria-hidden="true"><path d="M21.801 10A10 10 0 1 1 17 3.335"></path><path d="m9 11 3 3L22 4"></path></svg><span class="leading-snug">401k</span></div><div class="flex items-start gap-2 text-sm text-slate-600"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-circle-check-big w-3.5 h-3.5 text-emerald-500 flex-shrink-0 mt-0.5" aria-hidden="true"><path d="M21.801 10A10 10 0 1 1 17 3.335"></path><path d="m9 11 3 3L22 4"></path></svg><span class="leading-snug">Life Insurance</span></div></div></div></div><div class="bg-white border border-slate-200 rounded-lg p-4 sm:p-6 space-y-6"><div class="text-center pb-6 border-b border-slate-200"><div class="inline-flex items-center justify-center w-20 h-20 rounded-full bg-slate-100"><span class="text-3xl font-bold text-slate-700">3.8</span></div><p class="text-sm text-slate-600 mt-2 font-medium">Burnout Score</p><div class="inline-block mt-2 px-3 py-1 bg-slate-100 text-slate-700 rounded-full text-xs font-semibold">Below Average</div></div><div class="bg-white rounded-lg p-3"><div class="flex items-center gap-2 mb-3"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-shield w-5 h-5 text-green-500" aria-hidden="true"><path d="M20 13c0 5-3.5 7.5-7.66 8.95a1 1 0 0 1-.67-.01C7.5 20.5 4 18 4 13V6a1 1 0 0 1 1-1c2 0 4.5-1.2 6.24-2.72a1.17 1.17 0 0 1 1.52 0C14.51 3.81 17 5 19 5a1 1 0 0 1 1 1z"></path></svg><h3 class="text-base sm:text-lg font-semibold text-slate-900">Protective Factors (1)</h3></div><div class="space-y-2 mb-3"><div class="flex items-start gap-2"><div class="mt-1.5"><div class="w-2 h-2 rounded-full bg-green-500"></div></div><div><p class="text-sm text-slate-700"><span class="font-semibold text-green-700">Remote work</span><span class="text-slate-500"> (RR 0.57; 14-23% ↓ burnout)</span></p></div></div></div><div class="pt-3 border-t border-slate-100"><p class="text-xs text-slate-500"><span class="font-semibold text-slate-700">Interpretation:</span> Position includes 1 validated protective factor against burnout.</p></div></div><div class="space-y-3 pt-4 border-t border-slate-200"><h3 class="font-semibold text-slate-900 text-sm flex items-center gap-2"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-activity w-4 h-4 text-slate-600" aria-hidden="true"><path d="M22 12h-2.48a2 2 0 0 0-1.93 1.46l-2.35 8.36a.25.25 0 0 1-.48 0L9.24 2.18a.25.25 0 0 0-.48 0l-2.35 8.36A2 2 0 0 1 4.49 12H2"></path></svg>Job Details</h3><div class="flex items-start gap-2"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-briefcase w-4 h-4 text-slate-400 mt-0.5 flex-shrink-0" aria-hidden="true"><path d="M16 20V4a2 2 0 0 0-2-2h-4a2 2 0 0 0-2 2v16"></path><rect width="20" height="14" x="2" y="6" rx="2"></rect></svg><div><p class="text-xs text-slate-500">Employment Type</p><p class="text-sm font-medium text-slate-900">Full-time</p></div></div><div class="flex items-start gap-2"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-clock w-4 h-4 text-slate-400 mt-0.5 flex-shrink-0" aria-hidden="true"><path d="M12 6v6l4 2"></path><circle cx="12" cy="12" r="10"></circle></svg><div><p class="text-xs text-slate-500">Posted</p><p class="text-sm font-medium text-slate-900">1mo ago</p></div></div></div></div><div class="mt-4 flex flex-col gap-1"><a href="https://www.hioscar.com/careers/7449995?gh_jid=7449995" target="_blank" rel="noopener noreferrer" class="block w-full text-center px-4 py-2.5 bg-slate-900 text-white font-semibold rounded-lg hover:bg-slate-800 transition">Quick Apply →</a></div></div></div></div><div class="mt-8 sm:mt-12 pt-8 sm:pt-12 border-t border-slate-200"><h2 class="text-xl sm:text-2xl font-bold text-slate-900 mb-4 sm:mb-6">Similar Jobs</h2><div class="grid grid-cols-1 sm:grid-cols-2 lg:grid-cols-3 gap-4 sm:gap-6"><a class="block bg-white rounded-lg p-4 hover:border-cyan-300 hover:shadow-md transition-all border border-slate-200" href="/jobs/241dbc7b-c76b-418a-862e-fa86ca98dde0"><div class="flex justify-between items-start mb-2"><div><h3 class="font-semibold text-slate-900 text-sm line-clamp-2">Utilization Manager, Registered Nurse</h3></div><div class="flex-shrink-0 ml-2 px-1.5 py-0.5 rounded-full text-[10px] font-semibold flex items-center gap-0.5 bg-cyan-50 text-cyan-600 border border-cyan-100" 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line-clamp-2">Utilization Review Registered Nurse (RN) Part time, OK</h3></div><div class="flex-shrink-0 ml-2 px-1.5 py-0.5 rounded-full text-[10px] font-semibold flex items-center gap-0.5 bg-slate-100 text-slate-600 border border-slate-200" title="Work-Life Balance Score: 6.0/10">6.0/10</div></div><p class="text-sm text-slate-600 mb-2">Advocate Health</p><div class="flex items-center gap-2 text-xs text-slate-500 overflow-hidden"><span class="flex items-center gap-1 min-w-0 flex-shrink"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-map-pin w-3 h-3 flex-shrink-0" aria-hidden="true"><path d="M20 10c0 4.993-5.539 10.193-7.399 11.799a1 1 0 0 1-1.202 0C9.539 20.193 4 14.993 4 10a8 8 0 0 1 16 0"></path><circle cx="12" cy="10" r="3"></circle></svg><span class="truncate">Wisconsin</span></span><span class="flex items-center gap-1 min-w-0 flex-shrink"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-dollar-sign w-3 h-3 flex-shrink-0" aria-hidden="true"><line x1="12" x2="12" y1="2" y2="22"></line><path d="M17 5H9.5a3.5 3.5 0 0 0 0 7h5a3.5 3.5 0 0 1 0 7H6"></path></svg><span class="truncate">34.90–52.35 an hour</span></span><span class="text-slate-300 flex-shrink-0">•</span><button class="flex items-center gap-0.5 text-cyan-600 hover:text-cyan-700 transition-colors flex-shrink-0"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-chart-column w-3 h-3" aria-hidden="true"><path d="M3 3v16a2 2 0 0 0 2 2h16"></path><path d="M18 17V9"></path><path d="M13 17V5"></path><path d="M8 17v-3"></path></svg><span class="underline">Intel</span></button></div></a><a class="block bg-white rounded-lg p-4 hover:border-cyan-300 hover:shadow-md transition-all border border-slate-200" href="/jobs/26a5b1c0-038a-4852-bbf4-195d0207b5e7"><div class="flex justify-between items-start mb-2"><div><h3 class="font-semibold text-slate-900 text-sm line-clamp-2">Utilization Review Nurse (Remote)</h3></div><div class="flex-shrink-0 ml-2 px-1.5 py-0.5 rounded-full text-[10px] font-semibold flex items-center gap-0.5 bg-slate-100 text-slate-600 border border-slate-200" title="Work-Life Balance Score: 6.0/10">6.0/10</div></div><p class="text-sm text-slate-600 mb-2">Martin's Point Health Care</p><div class="flex items-center gap-2 text-xs text-slate-500 overflow-hidden"><span class="flex items-center gap-1 min-w-0 flex-shrink"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide 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Loading?\u003c/h1\u003e\u003cp class=\\\"error-subtitle\\\"\u003eIt looks like JavaScript is disabled in your browser. Unfortunately, you won’t be able to use hioscar.com without JavaScript enabled. Your browser’s support site can show you \u003ca href=\\\"https://support.google.com/chrome/answer/114662\\\"\u003ehow to enable JavaScript \u003c/a\u003e.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003eSkip to main content1-855-672-2788 English Log inOverviewAll jobsClinicalPhysician Reviewer - Utilization ManagementRemoteHi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team.\\nOscar 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.\\n\\n**\\n**About Us**\\n\\n Role**\\n\\n:\\nYou will determine the medical appropriateness of inpatient, outpatient, and pharmacy services by reviewing clinical information and applying evidence-based guidelines.\\n\\n**Work Schedule**\\n\\n: 8am - 5pm in your local time zone\\nCall rotation - 1 weekend every 16 weeks\\nYou will report into the Associate Medical Director, Utilization Management.\\nWork Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote\\n\\n**Benefits \u0026 Compensation**\\n\\n Transparency: The base \\n\\n**Benefits \u0026 Compensation**\\n\\n for this role is: $211,200 - $ 277,200 per year. 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class=\"error-subtitle\"\u003eIt looks like JavaScript is disabled in your browser. Unfortunately, you won’t be able to use hioscar.com without JavaScript enabled. Your browser’s support site can show you \u003ca href=\"https://support.google.com/chrome/answer/114662\"\u003ehow to enable JavaScript \u003c/a\u003e.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003eSkip to main content1-855-672-2788 English Log inOverviewAll jobsClinicalPhysician Reviewer - Utilization ManagementRemoteHi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team.\nOscar 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.\n\n**\n**About Us**\n\n Role**\n\n:\nYou will determine the medical appropriateness of inpatient, outpatient, and pharmacy services by reviewing clinical information and applying evidence-based guidelines.\n\n**Work Schedule**\n\n: 8am - 5pm in your local time zone\nCall rotation - 1 weekend every 16 weeks\nYou will report into the Associate Medical Director, Utilization Management.\nWork Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote\n\n**Benefits \u0026 Compensation**\n\n Transparency: The base \n\n**Benefits \u0026 Compensation**\n\n 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.\n\n**Key Responsibilities**\n\n:\n\nProvide timely medical reviews that meet Oscar's stringent quality parameters\n• Provide clinical determinations based on evidence-based criteria and Oscar internal guidelines and policies, while utilizing clinical acumen.\nClearly 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).\nUse correct templates for documenting decisions during case review.\nMeet the appropriate turn-around times for clinical reviews.\nReceive and review escalated reviews\n• 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.\nCompliance with all applicable laws and regulations\nOther duties as assigned\n\n**Requirements**\n\n:\n\nBoard certification as an MD or DO\nLicensed in FL or NC and/or active Interstate Medical Licensure Compact (IMLCC) or eligible to apply for IMLCC.\n6+ years of clinical practice\n1+ years of utilization review experience in a managed care plan (health care industry)\n\nBonus points:\n\nLicensure in multiple Oscar states\nBC in Cardiology, Radiation/Oncology, or Neurology\nExperience with care management within the health insurance industry.\nWilling and able to obtain additional state licensure as needed, with Oscar's support\nThis is an authentic Oscar Health job opportunity. Learn more \n\n**About Us**\n\n you can safeguard yourself from recruitment fraud here. \nAt 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.\n\n**Benefits \u0026 Compensation**\n\n Transparency: Final offer amounts, within the base \n\n**Benefits \u0026 Compensation**\n\n 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 ins"])</script><script>self.__next_f.push([1,"1a:T5df,## About the Role\n$211K-$277K. Remote. 8-5 local time. Weekend call 1:16. 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Physician Reviewer - Utilization Management

Job Description

About the Role

Work-Life Balance Factors

Key Responsibilities