Strategic Physician Reviewer, Utilization Management

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

Job summary

ChenMed in Miami, FL is seeking a Physician Reviewer to lead Utilization Management reviews for our patient population. The role involves analyzing cases, coordinating with health plans and local teams, and contributing to care coordination across markets.

You will cover assigned territories, participate in daily calls, and mentor other reviewers. The position supports process and quality improvement in delegated UM and requires a medical degree, residency in Internal Medicine or Family

Qualifications

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

Responsibilities

• Provides Delegated UM by covering territories; establishes 2-3 cases daily per market; attends weekly calls.
• Advises other physician reviewers.
• Other duties as assigned and modified by manager.

Skills

Analytical skills

Judgement

Communication skills

Organizational skills

English fluency

Education

MD/DO degree

Internal Medicine residency

Family Medicine residency

Board certification

Hospital medicine experience

Utilization review experience

Tools

Microsoft Office

Job description

ChenMed in Miami, FL is seeking a Physician Reviewer to lead Utilization Management reviews for our patient population. The role involves analyzing cases, coordinating with health plans and local teams, and contributing to care coordination across markets.

You will cover assigned territories, participate in daily calls, and mentor other reviewers. The position supports process and quality improvement in delegated UM and requires a medical degree, residency in Internal Medicine or Family