Remote Physician Reviewer — Utilization Management Expert

ChenMed; United States; Remote; USD 205,000 - 293,000; Full time

Job summary

ChenMed is seeking a Physician Reviewer to serve as the primary physician reviewer for Utilization Management (UM) cases. You will cover specified territories, participate in health plan discussions, and coordinate care with local teams.

The role includes advising other reviewers and contributing to ongoing quality and process improvements. Ideal candidates hold an MD with a valid license and board certification in Internal Medicine or Family Practice, plus hospital medicine and utilization

Qualifications

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

Responsibilities

• Provide Delegated UM by covering assigned territories and establishing 2-3 cases per day.
• Advise other physician reviewers.
• Participate in Process and Quality improvement initiatives and in delegated UM activities.

Skills

Analytical reasoning

Judgement

Communication

Organization

English fluency

MS Office

Education

MD license

Internal Medicine/Family Practice residency

Board certification

Hospital medicine experience

Utilization review experience

Job description

ChenMed is seeking a Physician Reviewer to serve as the primary physician reviewer for Utilization Management (UM) cases. You will cover specified territories, participate in health plan discussions, and coordinate care with local teams.

The role includes advising other reviewers and contributing to ongoing quality and process improvements. Ideal candidates hold an MD with a valid license and board certification in Internal Medicine or Family Practice, plus hospital medicine and utilization