Independent Contractor Physician
Utilization Management & Medical Affairs Consultant (1099)

ATTAC Consulting Group is engaging a physician consultant to provide clinical expertise and medical judgment across utilization management, care management, quality improvement, medical policy, and population health work for Medicare Advantage, Medicaid, and ACA Marketplace health plans. This is a 1099 independent contractor role: remote, project-based, and scoped to organizational need. The physician exercises independent medical judgment and works alongside our nurses, care managers, pharmacists, quality specialists, and provider relations teams.

What You’ll Do

  • Participate in audits of Medicare Advantage decisions for medical necessity and appropriateness of care, applying evidence-based clinical guidelines and nationally recognized criteria (InterQual®, MCG, CMS NCDs/LCDs).
  • Participate in peer-to-peer discussions with health plan or delegate staff and support authorization and coverage determinations.
  • Provide clinical oversight for Medicare Advantage UM programs, interpreting CMS regulations and Medicare coverage criteria, and supporting CMS audit readiness.
  • Support Medicaid managed care reviews, including LTSS, behavioral health integration, HCBS, and complex care management, with attention to health equity and access-to-care initiatives.
  • Advise on ACA Marketplace benefit determinations and population health strategies for quality measures, preventive care, and chronic disease management.
  • Contribute to development and review of medical necessity criteria, UM policy, and clinical program design.

Qualifications

Required

  • MD or DO from an accredited institution.
  • Active, unrestricted physician license in a U.S. state, DC, or U.S. territory.
  • 5+ years’ experience with managed care or health plan operations.

About ATTAC Consulting Group

Founded in 2003, ATTAC Consulting Group is a national firm that health plans, providers, and regulators trust to deliver compliance, audit, and operational solutions that stand up to scrutiny and drive measurable results. ATTAC supports organizations across Medicare Advantage, Medicare Part D, Medicaid, Duals and LTSS, Commercial, and ACA lines of business through five integrated practice areas: Risk Adjustment, Auditing, Provider Networks, Compliance Solutions, and Business Transformation.

How to Express Interest

Send a brief introduction and your CV to or submit the form.

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