Job Title: Advisor Medical Expert – Physical Medicine & Rehabilitation (PM&R Physician)

Location: 100% Remote (Must reside within the Continental US)

Schedule: Monday – Friday, Pacific Standard Time (PST) Business Hours

License Requirement: Active, unrestricted California Medical License (MD or DO)

About The Opportunity

We are seeking an experienced Physical Medicine & Rehabilitation (PM&R) Physician to provide senior-level clinical expertise supporting Medicaid rehabilitation and healthcare programs.

In this role, you will apply your extensive PM&R experience to evaluate complex cases, assess medical necessity, and ensure members receive appropriate, evidence-based rehabilitation and related services. You will collaborate closely with treating providers, clinical teams, clients, and healthcare leadership on cases covering rehabilitation, pain management, functional restoration, durable medical equipment (DME), prosthetics, orthotics, and related therapies.

This position is an exciting opportunity to leverage your clinical knowledge in a non-clinical role that blends complex medical review, physician-to-physician consultation, quality improvement, and clinical policy development.

Key Responsibilities & What You'll Do

• Clinical Expertise & Leadership: Serve as a subject-matter expert in Physical Medicine & Rehabilitation, functional restoration, and comprehensive rehabilitation services.
• Medical Review & Utilization Management: Evaluate complex authorization requests, appeals, and medical necessity cases involving PT, OT, ST, inpatient rehabilitation, DME, prosthetics, orthotics, and pain management.
• Evidence-Based Evaluation: Review clinical documentation and treatment plans to determine if requested services meet established, evidence-based rehabilitation guidelines and medical necessity standards.
• Peer-to-Peer Consultations: Conduct professional physician-to-physician discussions with treating providers to discuss clinical indications and treatment strategies.
• Interdisciplinary Collaboration: Provide high-level guidance to internal utilization management, case management, quality assurance, and operational teams.
• Policy & Strategy Development: Interpret Medicaid requirements and medical policies; contribute expert insights toward refining clinical policy, utilization strategies, and quality initiatives.
• Program Effectiveness: Support initiatives aimed at improving healthcare quality, patient outcomes, and appropriate access to care for Medicaid beneficiaries.

Qualifications & What We’re Looking For

• Education & Credentials:
• MD or DO degree from an accredited medical school.
• CURRENT, active, unrestricted California Medical License (Required).
• Board Certification in Physical Medicine & Rehabilitation (PM&R) (Required).
• Experience:
• Minimum of 5 years of clinical practice experience post-residency specializing in PM&R, functional restoration, musculoskeletal care, pain management, or disability management.
• Prior experience working with Medicaid programs, coverage rules, and policy guidelines.
• Experience performing utilization management, prior authorizations, medical necessity reviews, or appeals.
• Knowledge & Skills:
• Strong mastery of rehabilitation care, physical therapy, occupational therapy, speech therapy, DME, prosthetics, and orthotics.
• Familiarity with evidence-based clinical guidelines (e.g., MCG, InterQual, or state-specific Medicaid guidelines).
• Exceptional clinical judgment, decision-making, analytical thinking, and communication skills.
• Ability to work effectively and independently in a 100% remote work setting during PST business hours.

Why Join Us?

• 100% Remote Flexibility: Enjoy the convenience of working from home anywhere in the continental United States.
• Impactful Non-Clinical Role: Apply your hard-earned clinical expertise to influence quality of care, policy, and medical access without direct patient care duties.
• Collaborative Environment: Engage in meaningful peer-to-peer dialogues and multidisciplinary team problem-solving.
• Work-Life Balance: Structured Monday through Friday PST hours.
• Employee Benefits: Full-time candidates are eligible for a generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance.

For additional information regarding this opportunity, please contact:

Holly Benson ​

Healthcare Recruiter, Judge Healthcare

P: (610) 628-5496 | Ext: 9514 | E: hbenson@judge.com | judge.com

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