Orthopedic Physician Reviewer for Utilization Management

ChenMed; Miami (FL); On-site; USD 204,761 - 292,515; Full time

Job summary

ChenMed is seeking a Physician Reviewer to lead Utilization Management (UM) reviews across assigned markets and coordinate care for our patients. You will cover delegated UM, attend health plan and local calls, and participate in quality improvement within our growing UM area.

The role requires a medical degree, residency in Internal Medicine or Family Practice, board certification, and strong analytical, communication, and organizational skills.

Qualifications

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

Responsibilities

• Establish 2-3 cases daily for each market covered (up to 6 markets); attend health plan and local calls; participate in 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

MS Office

Education

Medical degree from accredited school with unrestricted license

Internal Medicine or Family Practice residency

Board Certification in residency area - Orthopedics

2 years’ hospital medicine experience

1 year of utilization review experience

Tools

Microsoft Office

Job description

ChenMed is seeking a Physician Reviewer to lead Utilization Management (UM) reviews across assigned markets and coordinate care for our patients. You will cover delegated UM, attend health plan and local calls, and participate in quality improvement within our growing UM area.

The role requires a medical degree, residency in Internal Medicine or Family Practice, board certification, and strong analytical, communication, and organizational skills.