Physician Reviewer
Software Engineering
Richardson, TX, USA
Posted on Sep 24, 2026
Advisor Medical Expert - Internal Medicine Physician
Location: 100% Remote (Continental U.S.)
Schedule: Monday-Friday, Pacific Time business hours
Licensure Required: Active California Medical License
Overview
Seeking a Board-Certified Internal Medicine or Primary Care Physician to support medical necessity reviews, appeals, utilization management activities, and complex case evaluations within government-sponsored healthcare programs. This fully remote position allows physicians to leverage their clinical expertise outside of direct patient care while influencing quality, access, and appropriate utilization of healthcare services.
Responsibilities
- Review medical necessity determinations, prior authorizations, and appeals
- Conduct peer-to-peer discussions with treating providers
- Evaluate inpatient, outpatient, post-acute, and specialty care cases
- Apply evidence-based medicine and clinical guidelines to decision-making
- Provide clinical consultation to utilization management and care management teams
- Assist with policy development, quality initiatives, and complex case reviews
Qualifications
- MD or DO
- Active, unrestricted California medical license
- Board Certification in Internal Medicine, Family Medicine, or related primary care specialty
- 5+ years of post-residency clinical experience
- Strong background in evidence-based medicine and chronic disease management
- Prior utilization management, payer, medical review, or Medicaid experience preferred
Highlights
- Fully remote
- No direct patient care
- Influence healthcare quality and utilization decisions
- Collaborative multidisciplinary team environment
- Opportunity to impact Medicaid member care at scale
Ideal Candidate
This is likely a strong fit for:
- Internal Medicine physicians
- Family Medicine physicians
- Hospitalists
- Physicians currently performing utilization review, disability reviews, peer reviews, or health plan medical director work
- Clinicians looking to transition away from full-time patient care while remaining clinically engaged
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