Physician Reviewer — Utilization Management for Senior Care

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

Job summary

ChenMed is seeking a Physician Reviewer to lead Utilization Management cases across multiple markets. The role covers delegated UM duties, coordination with health plans, and collaboration with local teams to ensure optimal patient care.

A medical degree, active unrestricted license, and Internal Medicine/Family Practice residency are required, with endocrine board certification preferred. Ideal candidates have hospitalist experience and at least one year in utilization review, with strong

Qualifications

• Graduate from accredited Medical School with a valid, unrestricted license.
• Completion of Internal Medicine or Family Practice residency.
• Board Certification in Endocrinology.
• Two years of hospital medicine experience preferred; at least one year of utilization review experience preferred.

Responsibilities

• Provide Delegated UM by covering specified territories (2–3 cases/day per market; up to 6 markets).
• Advise other physician reviewers and participate in health plan/local calls.
• Participate in Process and Quality improvement within Delegated Utilization Management.

Skills

Analytical skills

Deductive reasoning

Communication skills

Organizational skills

English fluency

Education

Medical degree

Internal Medicine or Family Practice residency

Board Certification in Endocrinology

Tools

Microsoft Office (Outlook, Excel, Word, PowerPoint)

Job description

ChenMed is seeking a Physician Reviewer to lead Utilization Management cases across multiple markets. The role covers delegated UM duties, coordination with health plans, and collaboration with local teams to ensure optimal patient care.

A medical degree, active unrestricted license, and Internal Medicine/Family Practice residency are required, with endocrine board certification preferred. Ideal candidates have hospitalist experience and at least one year in utilization review, with strong