Licensed Physician Reviewer- Pulmo (remote)

ChenMed LLC; Miami (FL); Remote; USD 250,000 - 300,000; Full time

Job summary

ChenMed LLC is seeking a Physician Reviewer responsible for conducting Clinical Appropriateness Reviews and advising fellow physician reviewers. The role requires a medical degree and significant expertise in both Internal Medicine and Pulmonology, coupled with the ambition to redefine patient care for seniors in a growing healthcare environment. Join our innovative team to transform healthcare and experience comprehensive benefits and career advancement opportunities.

Benefits

Great compensation

Comprehensive benefits

Career development opportunities

Work-life balance

Qualifications

• Two years’ experience in Hospital medicine preferred.
• At least one year of utilization review experience preferred.

Responsibilities

• Provides Clinical Appropriateness Reviews covering specified territories.
• Advises other physician reviewers on clinical decisions.

Skills

Analytical skills

Judgment

Problem-solving

Communication

Organization

Fluency in English

Education

Graduate from accredited Medical School

Completion of Internal Medicine or Family Practice residency

Fellowship in Pulmonology

Board Certification in residency area

Board Certification in Pulmonology

Tools

Microsoft Office

Job description

We’re unique. You should be, too.

We’re changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?

We’re different than most primary care providers. We’re rapidly expanding and we need great people to join our team.

The Physician Reviewer is the primary physician reviewer for Clinical Appropriateness Reviews in our organization. Other duties include advising other physician reviewers and attending daily calls with health plan teams and our local teams assisting with this function and coordinating care for our patients. The position will also participate in Process and Quality improvement in our developing area of Delegated Utilization Management.

ESSENTIAL JOB DUTIES/RESPONSIBILITIES:

• Provides Clinical Appropriateness Reviews by covering the specified territories as assigned:
  • Establish 2-3 cases a day for each market covered (up to 6 markets); ensures attendance on all health plan and local calls; calls in for the weekly Primary Care Provider (PCP) and Skilled Nursing Facility (SNF) meetings covering the assigned territories.
• Advises other physician reviewers.
• Other duties as assigned and modified by manager.

KNOWLEDGE, SKILLS AND ABILITIES:

• Excellent analytical and deductive reasoning skills
• Good judgement and problem-solving skills
• Professional and effective communication skills
• Strong organizational skills
• Written and verbal fluency in English
• Proficient in the use of Microsoft Office products such as Outlook, Excel, Word and PowerPoint

EDUCATION AND EXPERIENCE CRITERIA:

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

We’re ChenMed and we’re transforming healthcare for seniors and changing America’s healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We’re growing rapidly as we seek to rescue more and more seniors from inadequate health care.

ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people’s lives every single day.

Current Employee apply HERE

Current Contingent Worker please see job aid HERE to apply