Utilization Management Physician Reviewer – Pediatric Medicaid ACO in Cincinnati, OH for Cincinnati Children's

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Utilization Management Physician Reviewer – Pediatric Medicaid ACO

The Utilization Management (UM) Physician Reviewer at Cincinnati Children’s ensures that pediatric Medicaid members receive medically necessary, evidence-based, and cost-effective care. Working within an Accountable Care Organization (ACO) model, this role supports care quality, utilization efficiency, and compliance with Medicaid regulations. The position involves clinical review, interdisciplinary collaboration, and strategic input into population health initiatives. This position is remote with a schedule of Monday through Friday 8:00am-5:00pm EST with minimal weekend and holiday on call requirements. Telecommuting on a full-time basis may be permitted in the following states: Alabama, Arizona, Arkansas, Florida, Georgia, Idaho, Iowa, Kansas, Louisiana, Michigan, Mississ

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