Senior Physician Reviewer, Utilization Management

ChenMed; Miami (FL); On-site; USD 205,000 - 293,000; Full time

Job summary

ChenMed is seeking a Physician Reviewer to lead Utilization Management review across multiple markets. The role requires medical training, IM/FP residency, and pain management certification, with experience in hospital medicine and utilization review preferred.

The position includes attending calls with health plans, coordinating care, and supporting continuous process improvements within a growing organization that values patient-centered care and team collaboration.

Qualifications

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

Responsibilities

• Provide Delegated UM by covering the specified territories as assigned (up to 6 markets).
• Attend health plan and local calls; participate in PCP/SNF meetings.
• Advise other physician reviewers and support process and quality improvement in UM.

Skills

Analytical reasoning

Judgment

Communication

Organizational skills

English fluency

MS Office

Education

MD/DO or medical degree

Internal Medicine or Family Practice residency

Board Certification in Pain Management

Tools

Microsoft Office

Job description

ChenMed is seeking a Physician Reviewer to lead Utilization Management review across multiple markets. The role requires medical training, IM/FP residency, and pain management certification, with experience in hospital medicine and utilization review preferred.

The position includes attending calls with health plans, coordinating care, and supporting continuous process improvements within a growing organization that values patient-centered care and team collaboration.