Utilization Management Physician (UMP) - Remote - Florida
Company: Protouch Staffing
Location: Daytona Beach
Posted on: February 28, 2026
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Job Description:
Job Description Utilization Management Physician (UMP) - Remote
Full-Time | 40 Hours Weekly A leading healthcare organization is
seeking an experienced Utilization Management Physician (UMP) for a
full-time remote opportunity. This role is ideal for a physician
with strong clinical judgment, managed care experience, and
expertise in medical necessity review and evidence-based
decision-making. The position is primarily remote, with occasional
on-site attendance required for meetings and committee
participation in Daytona Beach, Florida . Position Highlights
Remote full-time role 40 hours per week Bonus opportunity Must be
available via phone, email, and Microsoft Teams On-site presence
required periodically for meetings/committees Location: Daytona
Beach, FL Key Responsibilities Review and render determinations
for: Pre-authorization requests Initial and concurrent clinical
reviews Post-service decisions, including claims and appeals Apply
medical necessity criteria using nationally recognized guidelines,
including: MCG (Milliman Care Guidelines) InterQual CMS
(Medicare/Medicaid) standards Internal protocols and coverage
documents Participate in annual review and updates of clinical
criteria and scripts Provide physician support and guidance to
Utilization Management staff Conduct peer-to-peer discussions with
treating providers (phone or electronic) Assist with provider
education regarding treatment protocols and best practices
Participate in medical and utilization management committees as
requested Patient/Plan Focus This role supports utilization review
across multiple plan types, including: Medicare Medicaid Commercial
health plans Requirements MD or DO from an accredited medical
school Active, unrestricted Florida medical license Board
certification in primary specialty preferred Minimum 3 years'
experience as a Utilization Management Physician 3-7 years of
overall clinical experience Knowledge of managed care health plan
operations and benefits Strong working knowledge of medical policy
application and evidence-based criteria Willingness to participate
in audit/interrater reliability processes to ensure consistency
Compensation & Benefits Annual bonus opportunity 401(k) retirement
plan Health benefits for provider and eligible dependents
Malpractice insurance provided Paid leave time CME stipend
Licenses, fees, and dues reimbursement Travel reimbursement
Location Remote (Florida) Occasional on-site meetings in Daytona
Beach, FL
Keywords: Protouch Staffing, Port Orange , Utilization Management Physician (UMP) - Remote - Florida, Healthcare , Daytona Beach, Florida
