Lead Physician Reviewer - Utilization Management

ChenMed; Miami (FL); On-site; USD 205,000 - 293,000; Full time

Job summary

ChenMed in Florida seeks a Physician Reviewer to lead Utilization Management reviews and coordinate care with health plan teams for multiple markets. You must hold a medical license with board certification and possess experience in hospital medicine or utilization review.

The role supports a physician-led organization focused on improving senior care, with ongoing opportunities for professional development and cross-functional collaboration across local teams.

Qualifications

• Graduate from accredited Medical School with a valid, unrestricted license.
• Completion of Internal Medicine or Family Practice residency.
• Board Certification in residency area.
• Two (2) years' experience in Hospital medicine preferred.
• At least one (1) year of utilization review experience preferred.

Responsibilities

• Provides Delegated UM by covering the specified territories as assigned: establish 2-3 cases a day for each market covered; ensure attendance on all health plan and local calls; calls in for weekly PCP and SNF meetings.
• Advises other physician reviewers.
• Other duties as assigned and modified by manager.

Skills

Analytical skills

Judgement

Communication

Organizational skills

English fluency

Education

Medical school with license

Internal Medicine or Family Practice residency

Board certification

Hospital medicine experience

Utilization review experience

Tools

Microsoft Office

Job description

ChenMed in Florida seeks a Physician Reviewer to lead Utilization Management reviews and coordinate care with health plan teams for multiple markets. You must hold a medical license with board certification and possess experience in hospital medicine or utilization review.

The role supports a physician-led organization focused on improving senior care, with ongoing opportunities for professional development and cross-functional collaboration across local teams.