Physician Reviewer - Genetic Testing

Advisor Medical Expert - Genetics / Genetic Testing Physician Location: 100% Remote (Continental U.S.) Schedule: Monday-Friday, Pacific Time business hours Licensure Required: Active California Medical License Overview Seeking a Board-Certified Genetics Physician to support medical necessity reviews, appeals, prior authorizations, and complex case evaluations involving genetic testing, genomics, hereditary conditions, molecular diagnostics, and precision medicine within government-sponsored healthcare programs. This fully remote role offers the opportunity to apply specialized genetics expertise outside of direct patient care while helping ensure appropriate utilization of emerging genetic and genomic services. Responsibilities Review medical necessity determinations, prior authorizations, and appeals involving genetic and genomic testing Evaluate cases related to molecular diagnostics, hereditary disorders, rare diseases, pharmacogenomics, and precision medicine Conduct peer-to-peer discussions with treating providers Apply evidence-based guidelines to determine appropriateness of genetic testing services Provide clinical consultation to utilization management, case management, quality, and operational teams Collaborate with physicians, genetic counselors, laboratories, and healthcare stakeholders Assist with development of clinical policies and utilization management strategies Qualifications MD or DO Active, unrestricted California medical license Board Certification in Medical Genetics and Genomics, Clinical Genetics, or related specialty 5+ years of post-residency genetics or genomics experience Strong understanding of genetic testing, hereditary disease evaluation, and genomic medicine Ability to interpret complex clinical information and make sound medical necessity determinations Excellent communication and analytical skills Preferred Experience Molecular diagnostics Genomic testing programs Hereditary cancer syndromes Rare and hereditary diseases Pharmacogenomics and precision medicine Medicaid or government healthcare programs Utilization management, prior authorization, appeals, or medical review Highlights Fully remote physician opportunity No direct patient care Work at the intersection of genetics, genomics, and healthcare policy Influence coverage decisions involving advanced diagnostic technologies Collaborate with genetic counselors, laboratories, and multidisciplinary clinical teams Help shape appropriate access to genetic testing and precision medicine services Ideal Candidate This role is most likely to attract: Medical Genetics & Genomics physicians Clinical Geneticists Physicians with substantial genetics/genomics leadership responsibilities Academic genetics physicians seeking reduced clinical workloads Physicians currently performing utilization review, laboratory medical review, payer-based genetics evaluations, or genomic policy work