Licensed Physician Reviewer - Ortho (remote)

ChenMed; Miami (FL); Remote; USD 100,000 - 125,000; Full time

Job summary

A healthcare provider based in Florida seeks a Physician Reviewer to oversee clinical appropriateness reviews. This role involves coordinating with health plan teams and ensuring effective communication. The ideal candidate will hold a valid medical license and have experience in hospital medicine and utilization review. ChenMed offers competitive compensation and comprehensive benefits, fostering a supportive environment for growth and work-life balance.

Benefits

Great compensation

Comprehensive benefits

Career development opportunities

Work-life balance

Qualifications

• Two years of experience in Hospital medicine preferred.
• At least one year of utilization review experience preferred.

Responsibilities

• Provides Delegated Clinical Appropriateness Reviews covering specified territories.
• Establishes 2-3 cases a day for each market covered.
• Advises other physician reviewers.

Skills

Excellent analytical and deductive reasoning skills

Good judgement and problem-solving skills

Professional and effective communication skills

Strong organizational skills

Written and verbal fluency in English

Proficient in Microsoft Office

Education

Graduate from accredited Medical School

Completion of Internal Medicine or Family Practice residency

Completion of Orthopedic Surgery Fellowship

Board Certification in residency

Board Certification in Orthopedic Surgery

Job description

We’re unique. You should be, too.

We’re changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?

We’re different than most primary care providers. We’re rapidly expanding and we need great people to join our team.

Overview

The Physician Reviewer is the primary physician reviewer for Utilization Management/Clinical Appropriateness review cases in our organization. Other duties include advising other physician reviewers and attending daily calls with health plan teams and our local teams assisting with this function and coordinating care for our patients. The position will also participate in Process and Quality improvement in our developing area of Delegated Utilization Management.

ESSENTIAL JOB DUTIES/RESPONSIBILITIES

• Provides Delegated Clinical Appropriateness Reviews by covering the specified territories as assigned
• Establish 2-3 cases a day for each market covered (up to 6 markets); ensures attendance on all health plan and local calls; calls in for the weekly Primary Care Provider (PCP) and Skilled Nursing Facility (SNF) meetings covering the assigned territories
• Advises other physician reviewers
• Other duties as assigned and modified by manager

KNOWLEDGE, SKILLS AND ABILITIES

• Excellent analytical and deductive reasoning skills
• Good judgement and problem-solving skills
• Professional and effective communication skills
• Strong organizational skills
• Written and verbal fluency in English
• Proficient in the use of Microsoft Office products such as Outlook, Excel, Word and PowerPoint

EDUCATION AND EXPERIENCE CRITERIA

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

We’re ChenMed and we’re transforming healthcare for seniors and changing America’s healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We’re growing rapidly as we seek to rescue more and more seniors from inadequate health care.

ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people’s lives every single day.

Current Employee apply HERE (https://careers.chenmed.com/i/us/en/homerevisited)

Current Contingent Worker please see job aid HERE to apply

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