Remote Physician Reviewer — Utilization & Care Quality

ChenMed LLC

United States

Remote

USD 204,761 - 292,515

Full time

14 days+

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Job summary

ChenMed LLC is seeking a Physician Reviewer to lead delegated utilization management (UM) reviews across multiple markets. You will establish daily case counts, attend essential calls with health plans, advise other reviewers, and participate in ongoing process and quality improvements.

A strong medical background with licensure and board certification is required. Two years in hospital medicine and at least one year in utilization review are preferred, with excellent analytical and

Qualifications

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

Responsibilities

Provides Delegated UM by covering specified territories: establish 2–3 cases daily per market; attend health plan and local calls; participate in PCP and SNF meetings.
Advise other physician reviewers; perform duties as assigned by manager.
Contribute to process and quality improvement in Delegated Utilization Management.

Skills

Analytical thinking

Problem solving

Communication

Organization

English fluency

MS Office

Education

Medical School graduate

Internal Medicine or Family Practice residency

Neurology board certification

Hospital medicine experience

Utilization review experience

Tools

Microsoft Office

Job description

A strong medical background with licensure and board certification is required. Two years in hospital medicine and at least one year in utilization review are preferred, with excellent analytical and

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