[Hiring] Licensed Physician Reviewer - Dermatology @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 assisting with this function.
• Coordinating care for our patients.
• Participating in Process and Quality improvement in Delegated Utilization Management.

ESSENTIAL JOB DUTIES/RESPONSIBILITIES:

• Provides Delegated UM by covering the specified territories as assigned.
• Establishes 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 residency area.
• 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.

Company Description

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.