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Cincinnati Children's

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  • 14 days ago

    Utilization Management Physician Reviewer Pediatric Medicaid ACO

    Cincinnati Children's - Cincinnati, OH, United States
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    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 ...

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