Senior Physician Reviewer – Utilization Management

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

Benefits offered by this job

Employee benefits

Job summary

ChenMed in Miami, FL is seeking a Physician Reviewer to serve as the primary physician reviewer for Utilization Management (UM) cases, advising colleagues and coordinating care with health plan teams and local teams.

The role emphasizes process and quality improvement in Delegated UM and requires an MD with Internal Medicine or Family Practice residency, board certification, and two years of hospital medicine experience. Strong analytical and communication skills are essential.

Qualifications

• Graduate from an accredited medical school with a valid, unrestricted license.
• Completion of Internal Medicine or Family Practice residency.
• Board certification in the residency area.

Responsibilities

• Provide Delegated UM by covering designated territories and participating in meetings.
• Establish 2-3 UM cases per day per market and attend weekly health plan/local calls.
• Advise other physician reviewers and coordinate care with teams.
• Perform other duties as assigned and updated by management.

Skills

Analytical skills

Judgement

Communication skills

Organizational skills

English fluency

MS Office proficiency

Education

Medical Degree (MD)

Internal Medicine residency

Board certification

Job description

ChenMed in Miami, FL is seeking a Physician Reviewer to serve as the primary physician reviewer for Utilization Management (UM) cases, advising colleagues and coordinating care with health plan teams and local teams.

The role emphasizes process and quality improvement in Delegated UM and requires an MD with Internal Medicine or Family Practice residency, board certification, and two years of hospital medicine experience. Strong analytical and communication skills are essential.