Company Overview
The Judge Group is an international leader in business technology consulting, talent solutions, and learning and development. With over 30 locations across the U.S., Canada & India, Judge is proud to partner with the best and brightest companies in business today, including over 60 of the Fortune 100. We serve organizations in financial services, healthcare, life sciences, insurance, government, aerospace & defense, manufacturing, and technology & telecommunications. Judge has always been committed to doing what’s right – for our colleagues, our client partners, and our communities. At Judge, we cultivate an inclusive environment that empowers our employees to produce their best work. As a family-owned business, we’re not just a high-performing team, but a high-performing family. Through building relationships and our cultural commitment to caring, we support one another. Our People-powered Business Solutions Talent & Executive Search From temporary consultants to C-level executives, The Judge Group works across all industries and domains to find exceptional talent. IT Consulting We take an end-to-end approach to technology, working alongside your teams to design, build, implement, and manage all of your organization’s IT resources. Our enterprise IT consulting services and solutions encompass the full technology spectrum, from IT and business transformation, and cloud migration to digital strategies and execution, strategic roadmaps and delivery, process and governance optimization, and IT infrastructure and wireless solutions. Learning Solutions As a leading provider of corporate learning services for companies of all sizes and industries, Judge employs a strategic approach to learning that meets organizational training goals while strengthening business outcomes. Regardless of when, where, or how you want to train your team, our solutions are engineered to engage and support employees throughout their learning journey.
About the job
Remote Physician Reviewer – Utilization Review
MUST HAVE a Texas medical license.
Position Type: Temp-to-Perm
Compensation:
- Hourly: $105/hour during the temporary phase.
- Permanent Salary: $220,000/year + $5,000 bonus after 6 months.
Overview:
We are seeking board-certified Internal Medicine or Family Medicine physicians to join a dynamic team in a fully remote utilization review role. This position involves conducting peer-to-peer calls and case reviews, ensuring compliance with state regulations and delivering evidence-based decisions.
Ideal candidates will have recent direct patient care experience (within the past 6 months), a strong understanding of Utilization Review (UR) processes, and a commitment to making UR their career.
Key Responsibilities:
- Perform peer-to-peer phone calls with treating providers to discuss denied prior authorizations, explain reasons for denial, and offer opportunities for providers to submit additional clinical information.
- Conduct case reviews to assess the medical necessity of treatment requests.
- Navigate step therapy issues and adjudicate prior authorization requests according to clinical guidelines and plan criteria.
- Work collaboratively with internal teams while maintaining professionalism and efficiency.
Schedule:
- Initial schedule: Monday-Friday, 7 AM – 6 PM (Mountain Time), no weekends during training.
- After training:
- 40 hours/week, staggered between 6 AM – 7 PM (MST).
- Rotational weekend coverage: 3 weekend days per month (days off during the week to compensate).
- Training Period: Three months with minimal time off allowed.
Qualifications:
- Licensure:
- Active, unrestricted Texas medical license.
- Clean licensure history with no significant malpractice or legal issues.
- Certification:
- Board certification in Internal Medicine or Family Medicine.
- Experience:
- Minimum 5 years of recent, full-time clinical care experience.
- Direct patient care experience within the past six months is mandatory.
- Prior Utilization Review or peer review experience is highly preferred.
Skills:
- Proficient in navigating multiple computer applications across three monitors.
- Strong understanding of insurance plan criteria and evidence-based clinical guidelines.
- Above-average computer literacy.
Additional Requirements:
- Commitment to working a set schedule with limited flexibility.
- Willingness to dedicate full focus to this position, without other conflicting priorities such as operating a private practice.
- A robust home internet connection with direct cable (no satellite or Wi-Fi).
Why Join Us?
This role offers the opportunity to utilize your clinical expertise in a non-patient care setting, staying engaged with emerging treatment modalities while maintaining work-life balance. You’ll be part of a collaborative, nationwide team of physicians making impactful decisions in healthcare.
If you are passionate about providing high-quality reviews and ensuring appropriate allocation of healthcare resources, this is the perfect role for you.
How to Apply:
APPLY