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Welcome to CommonSpirit Careers

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Utilization Management Physician Reviewer

  • Dignity Health Management Services
  • Bakersfield, California, Remote
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About Us

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 138 hospital-based locations, in addition to its home-based services and virtual care offerings.

Our Mission

As CommonSpirit Health, we make the healing presence of God known in our world by improving the health of the people we serve, especially those who are vulnerable, while we advance social justice for all. To learn more about a calling that defines and unites, please click here for more information about our mission, vision, and values.

The posted compensation range of $89.69 - $133.41 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.

Job ID
2026-455914
Employment Type
Part Time
Department
Utilization Review
Hours/Pay Period
40
Weekly Schedule
Part-time hours Monday - Friday (8:00am - 5:00pm PST); days/hours flexible
Shift
Day
Remote
Yes
Category
Case Management and Social Work

Job Summary and Responsibilities

As the Utilization Management (UM) Physician Reviewer, you will report to the Medical Director of UM and provide clinical expertise to ensure high-quality, medically necessary, and efficient patient care aligned with regulatory requirements. This role involves making direct decisions in prior authorization, concurrent review of hospitalized patients, and discharge planning.

Key responsibilities include clinical review of prior authorization, concurrent review, and retrospective review requests using critical thinking and established guidelines, interpreting benefit language, and accurate documentation. The reviewer will engage in peer-to-peer discussions with providers, collaborate with other healthcare professionals, and handle appeals and grievances. Ensuring compliance with federal, state, and accreditation standards is crucial.

The position also involves acting as a clinical liaison, participating in case reviews and fair hearing processes, identifying utilization trends, and contributing to policy development and quality improvement. The UM Physician Reviewer will guide UM nurses and clinical staff and stay current with evidence-based medical literature and healthcare trends.

***This position is remote, but will be expected to work PST business hours.  

***This position is part-time, working approximately 20 hours/week, with flexible days/hours.  The schedule includes weekend and holiday rotations ensuring coverage for urgent reviews.


Job Requirements

Minimum Qualifications:


- Clear and current California MD or DO license.
- Proficiency in using electronic health records and UM software platforms (after training).

Preferred Qualifications:


- 2+ years of experience in a direct patient care setting, Primary care specialty preferred.
- Experience in utilization management, medical review, or managed care setting preferred.
- Strong knowledge of clinical standards of care, NCQA requirements, CMS guidelines, and Medicaid / Medicare programs and dual eligible populations, and benefit systems preferred.

#UMPhysRev

Where You'll Work

The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.


Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.

One Community. One Mission. One California 

Total Rewards

Depending on the position offered, CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible team members may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit our Total Rewards

Unless directed by a Collective Bargaining Agreement, applications for this position will be considered on a rolling basis. CommonSpirit Health cannot anticipate the date by which a successful candidate may be identified.

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