[Hiring] Licensed Physician Reviewer @ChenMed

Role Description

The Physician Reviewer is the primary physician reviewer for Utilization Management (UM) cases in our organization. Other duties include:

• Advising other physician reviewers
• Attending daily calls with health plan teams and local teams
• Coordinating care for our patients
• Participating in Process and Quality improvement in Delegated Utilization Management

ESSENTIAL JOB DUTIES/RESPONSIBILITIES:

• Provides Delegated UM by covering 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
• Other duties as assigned and modified by manager

Qualifications

• 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

Requirements

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

Benefits

• Great compensation
• Comprehensive benefits
• Career development and advancement opportunities
• Work-life balance
• Opportunities to grow

Pay Range

$204,761 - $292,515 Salary. The posted pay range represents the base hourly rate or base annual full-time salary for this position. Final compensation will depend on a variety of factors including but not limited to experience, education, geographic location, and other relevant factors. This position may also be eligible for bonuses or commissions.