New Jersey Licensed Physician Reviewers - Generalist - Full Time

Job Description

Dane Street is an Independent Review Organization and a national provider of Group Health Review services (among other offerings). We are expanding our physician panel, resulting in opportunities for non-traditional physician work and supplemental income. This is a telework opportunity for physicians providing a caseload customized to your schedule.

Our physician panel comprises independent contract reviewers (1099) compensated on a per-case basis. We are looking for reviewers with an active license to address the medical necessity of treatment requests and, in appeals, the medical necessity of previously denied services.

The expectations for this role include:

• Initial availability of each physician between 8:00 p.m. and 5:00 p.m. Eastern Time. 8-hour shift.
• Working within the client's system, with paid training provided in advance of the start date. We will coordinate a suitable time for this training with you.
• Reviewing pre-authorization cases in accordance with MCG guidelines.
• Participating in peer-to-peer calls when required.
• Conducting reviews solely based on medical criteria.
• Producing an expected 40 cases per day.
• Utilizing a laptop to access the client's AWS system.

Requirements

• Hold an active NJ license
• Has currently or prior experience with UM experience dealing with Prior Authorization in UM platforms.
• Current, unrestricted Medical License
• Board Certified

Benefits

• Independent consultant role allows for schedule flexibility and predictable work hours. You choose services and case types, dictate volume, and conduct this work based on your scheduled availability.
• No doctor/patient relationship is established, and no treatment is provided. These are advisory-only opinions.
• Dane Street offers a streamlined case flow and a user-friendly work portal.
• We facilitate all communication, organize and sort all medical records, support all administrative processes, prep cases extensively, and ensure the quality and timely delivery of all determinations/reports.
• A chronological listing of medical records as well as all treatment guidelines used to make a determination are provided in an easy, click-to-view format.
• Dane Street offers initial training as well as an ongoing point of contact should you have any questions about completing reviews.

Additional Details

• Location Type: Remote
• Employment Type: Independent consultant
• Workplace: Remote
• Language: en
• Department: Group Health
• Published: 2025-07-31