Peer to Peer Physician
This is a remote position.
About Us
Our firm is built by former healthcare operators who understand the realities of running complex healthcare systems. This combination of operator credibility and investment-backed growth enables us to deliver high-impact, scalable solutions.
We differentiate ourselves by bringing practical experience, executive-level insight, and a relentless focus on quality and outcomes. Our success is directly tied to our clients’ success.
This is a short-term physician role focused on helping other physicians navigate utilization decisions and clinical approvals through peer-to-peer conversations. The work is centered on supporting ambulatory (outpatient) and long-term care settings, with a strong emphasis on clear clinical communication and practical decision-making.
This is a 6-week contract starting October 3, primarily supporting peer-to-peer provider discussions tied to Lumens and other ambulatory clinical applications.
What You’ll Do
In this role, you’ll act as a clinical peer resource for other physicians when there are questions or challenges around approvals, medical necessity, or care level decisions. Most of your work will involve direct physician-to-physician conversations and quick clinical reviews.
You will:
- Participate in peer-to-peer calls with treating providers to review clinical decisions and treatment plans
- Help clarify medical necessity decisions using evidence-based guidelines and standard clinical criteria
- Review patient documentation from ambulatory and long-term care settings to support those discussions
- Provide clear, practical clinical reasoning that helps move cases toward resolution
- Work within Lumens and other ambulatory systems to support workflow and documentation needs
- Collaborate with utilization management and care coordination teams on escalated or time-sensitive cases
- Support consistent, fair, and clinically appropriate decision-making across cases
- Focus: Peer-to-peer provider support
- Settings: Ambulatory and long-term care
- Systems: Lumens and related ambulatory clinical applications
Requirements
What We’re Looking For- MD or DO with an active, unrestricted U.S. medical license
- Board-certified physician
- Strong clinical background with experience applying guidelines in real-world decision-making
- Prior exposure to utilization management, prior auth, or peer-to-peer discussions is strongly preferred
- Comfortable working across outpatient and long-term care clinical environments
What You Bring- Strong clinical judgment and the ability to make decisions quickly and confidently
- Clear communication style when speaking with other physicians
- Comfort working within structured guidelines while still applying clinical nuance
- Experience with ambulatory workflows or EMR systems is helpful (especially Lumens or similar platforms)
- Ability to stay objective and solution-focused in peer discussions
Benefits
Benefits
What We Offer:
- Competitive salary and benefits package.
- Opportunity to work in a collaborative and innovative environment.
- Professional development opportunities to advance your career.
- Flexible work arrangements to promote work-life balance.
Originally posted on Himalayas