Licensed Physician Reviewer - Ortho (remote)

ChenMed LLC; Miami (FL); Remote; USD 200,000 - 250,000; Full time

Job summary

ChenMed LLC is seeking a Physician Reviewer to oversee clinical appropriateness cases as part of our expanding Utilization Management team in Miami. This role requires a valid medical license and completion of relevant residencies, ideally with experience in hospital medicine. Join us in transforming healthcare for seniors with a focus on quality improvement and patient care.

Benefits

Competitive compensation

Comprehensive benefits

Career development opportunities

Qualifications

• Requires a valid, unrestricted medical license.
• Two years’ experience in hospital medicine preferred.
• At least one year in utilization review preferred.

Responsibilities

• Conduct clinical appropriateness reviews for up to 6 markets.
• Advise and collaborate with other physician reviewers.
• Participate in process and quality improvement initiatives.

Skills

Analytical skills

Problem-solving

Effective communication

Organizational skills

Fluency in English

Education

Graduation from an accredited Medical School

Completion of Internal Medicine or Family Practice residency

Orthopedic Surgery Fellowship completion

Board Certification in residency and Orthopedic Surgery

Tools

Microsoft Office applications

Job description

We’re unique. You should be, too.

We’re changing lives every day for our patients and team members. Are you innovative and entrepreneurial? Is your work ethic and ambition exceptional? Do you inspire others with kindness and joy?

We’re different from most primary care providers. As we rapidly expand, we need great people to join our team.

Position Overview:

The Physician Reviewer is responsible for primary physician review of Utilization Management/Clinical Appropriateness cases within our organization. Responsibilities include advising other physician reviewers, attending daily calls with health plan teams and local teams, and coordinating patient care. The role also involves participating in process and quality improvement initiatives in our developing Delegated Utilization Management area.

ESSENTIAL JOB DUTIES/RESPONSIBILITIES:

• Conduct Delegated Clinical Appropriateness Reviews, covering designated territories as assigned, establishing 2-3 cases daily per market (up to 6 markets), and participating in all relevant meetings and calls.
• Advise and collaborate with other physician reviewers.
• Perform additional duties as assigned or modified by the manager.

KNOWLEDGE, SKILLS, AND ABILITIES:

• Excellent analytical and deductive reasoning skills
• Good judgment and problem-solving abilities
• Effective communication skills, both written and verbal
• Strong organizational skills
• Fluency in English
• Proficiency in Microsoft Office applications (Outlook, Excel, Word, PowerPoint)

EDUCATION AND EXPERIENCE REQUIREMENTS:

• Graduation from an accredited Medical School with a valid, unrestricted license
• Completion of Internal Medicine or Family Practice residency
• Orthopedic Surgery Fellowship completion
• Board Certification in residency and Orthopedic Surgery
• Preferred: Two years’ experience in hospital medicine and at least one year in utilization review

We’re ChenMed, transforming healthcare for seniors and improving America’s healthcare system. Family-owned and physician-led, our approach enhances the health and well-being of the populations we serve. We are growing rapidly, aiming to rescue more seniors from inadequate healthcare.

ChenMed offers competitive compensation, comprehensive benefits, career development, and opportunities for growth. Join our team that makes a difference every day.

Current Employee? Apply HERE

Current Contingent Worker? See the job aid HERE to apply.