Lead Physician Reviewer, Utilization Management

ChenMed LLC; United States; Remoto; USD 205.000 - 293.000; Tempo pieno

Descrizione del lavoro

ChenMed LLC is seeking a Physician Reviewer to serve as the primary physician reviewer for Utilization Management (UM) cases across multiple markets. You will participate in daily health plan calls, coordinate patient care with local teams, and support process and quality improvements in delegated UM.

The role requires board-certified internal medicine or family practice physicians with a valid license, hospital medicine and utilization review experience preferred.

Competenze

• 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.

Mansioni

• Provides Delegated UM by covering the specified territories and attending health plan/local calls.
• Advises other physician reviewers.
• Other duties as assigned and modified by manager.

Conoscenze

Analytical thinking

Judgement & problem solving

Communication skills

Organizational skills

English fluency

MS Office proficiency

Formazione

Medical school graduate with license

Internal Medicine or Family Practice residency

Board certification in specialty

Hospital medicine experience (2+ years)

Utilization review experience (1+ year)

Descrizione del lavoro

ChenMed LLC is seeking a Physician Reviewer to serve as the primary physician reviewer for Utilization Management (UM) cases across multiple markets. You will participate in daily health plan calls, coordinate patient care with local teams, and support process and quality improvements in delegated UM.

The role requires board-certified internal medicine or family practice physicians with a valid license, hospital medicine and utilization review experience preferred.