
This full-time Rheumatologist-Physician Reviewer role within the Radiology department focuses on utilization management for a health organization dedicated to improving complex care outcomes. The position involves reviewing imaging cases that do not meet initial medical necessity guidelines, conducting peer-to-peer discussions with providers to explain clinical determinations, and ensuring compliance with URAC and NCQA standards. The role offers a non-clinical environment that supports a strong work-life balance, autonomy, and a collaborative culture valuing continuous learning. The position is remote, requiring high-speed internet, and provides the opportunity to make a meaningful impact on patient care while mentoring initial reviewers.





