Remote Utilization Review Rn Jobs in Bothell, WA

Firefly Health is building a revolutionary new type of comprehensive health "care and coverage,” powered by a relationship-driven care team, a trusted virtual and in-person clinical network, and our proprietary technology platform.

Founded by experienced clinicians and technology leaders, Firefly Health is on a mission to deliver clinical and financial health through joyful, always there care. We are flipping the script on what it means to be a health plan and actually providing a true health benefit to members.

We are intensely focused on optimizing the physical + mental + financial wellbeing of those who want (and deserve) something better than the status quo. If you are ready to roll up your sleeves and take on our audacious mission, we would love to hear from you.

The Role

As a Virtual Primary Care Physician, you will have the opportunity to work within an innovative, integrated care model designed to deliver high-quality, relationship-based primary care through a virtual-first platform. You will practice as part of Firefly's multidisciplinary Care Team, collaborating closely with Nurse Practitioners (NPs), Registered Nurses (RNs), Health Guides, Behavioral Health Specialists, and other clinical partners to deliver coordinated, patient-centered care. As Firefly continues to scale its value-based care model, physicians play a critical role not only in direct patient care but also in clinical quality, provider development, population health management, and practice transformation.

In addition to providing direct patient care, you will serve as a clinical leader within the organization, helping ensure quality, consistency, and excellence across the practice. This includes supporting Nurse Practitioner development through collaborative practice oversight, participating in quality review activities, contributing to evidence-based clinical programs, and advancing Firefly's value-based care model.

Our clinicians leverage an extensive network of home diagnostics, laboratory, imaging, specialty, and community-based partners to provide comprehensive care for patients across a broad spectrum of acute, chronic, and preventive health needs.

This is an exciting opportunity for a physician who is passionate about transforming primary care, improving health outcomes through technology, and helping build the future of value-based healthcare.

You will:

• Provide comprehensive primary care to a diverse patient population in a fully virtual care environment
• Conduct virtual consultations to assess medical concerns, diagnose conditions, develop treatment plans, and coordinate ongoing care, including asynchronous care
• Serve as the supervising physician for Nurse Practitioners through collaborative practice agreements, including structured chart review, documentation review, coaching, clinical consultation, and professional development
• Contribute to total cost of care initiatives by supporting the management of high-complexity patients, promoting evidence-based care, and guiding appropriate utilization across the care continuum
• Participate in clinical quality improvement, peer review, and chart audit activities to promote consistent, evidence-based care delivery across assigned pod(s)
• Ensure accurate, complete, and clinically supported documentation that reflects patient complexity and supports quality measurement, care management, population health initiatives, and value-based care programs
• Utilize population health data, quality metrics, and care gap reporting to proactively improve outcomes across assigned patient panels and pod
• Contribute to the development, implementation, and ongoing refinement of evidence-based clinical programs, care pathways, and practice standards
• Take on- call shifts on a predictable schedule to support urgent patient needs after practice hours
• Participate in daily huddles and cross-functional care team activities to ensure coordinated, patient-centered care
• Thrive in a fast-paced, high-growth environment focused on innovation, collaboration, and continuous improvement
• Maintain multi-state licensure and associated CME requirements

You’ll be a good fit if you:

• Are a graduate of an accredited MD or DO residency program in Family Medicine or Internal Medicine
• Have at least five years of experience practicing in a primary care setting
• Maintain current board certification in Family Medicine or Internal Medicine
• Hold an active unrestricted physician license in MA and an additional 35+ states is highly desired
• Reside in the United States
• Have experience working collaboratively with Nurse Practitioners and interdisciplinary care teams
• Have demonstrated experience providing clinical oversight, mentorship, or supervision of advanced practice providers
• Have experience participating in clinical quality initiatives, peer review programs, chart audits, or quality improvement activities
• Have experience delivering care within value-based care models, including commercial risk arrangements or other risk-bearing care models, and understand the role of accurate clinical documentation, quality measurement, and population health initiatives in improving patient outcomes
• Possess excellent written and verbal communication skills with patients, colleagues, and cross-functional partners
• Have experience working at the intersection of healthcare delivery, technology, and innovation

It’d be nice if you:

• Have prior experience in virtual-first or telehealth enabled primary care models
• Hold a current Massachusetts Controlled Substance Registration and federal DEA registration
• Have experience in a rapidly scaling healthcare or digital health organization

The salary range for this position is $300,000 to $325,000 annually; as part of a total benefits package which includes health insurance, 401k, and bonus. In accordance with state applicable laws, Firefly Health is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including but not limited to qualifications for the role, experience level, skillset, and internal alignment.

Our office is in Watertown, Massachusetts, but we’ve developed a robust remote working structure to give us more geographical flexibility while hiring for many positions. This role can be done largely remotely, there are several times a year when staff come together onsite for planning and team building.

Firefly is an equal opportunity employer. We value diverse backgrounds and perspectives. We're committed to building and sustaining an inclusive workplace culture where individuals are treated with dignity and respect. All employment is decided on the basis of qualifications, merit, and business need. Firefly is an E-Verify employer.