Licensed Physician Reviewer- Orthopedics - PRN - Remote
ChenMed · Miami, FL · 1 mo ago
RemoteRemoteFinance$205k–$293k/yrFull-time
About the role
The Physician Reviewer is responsible for reviewing Utilization Management (UM) cases within the organization. Key responsibilities include providing delegated UM coverage, participating in health plan and local calls, and attending PCP and SNF meetings.
Responsibilities
- Provides Delegated UM by covering specified territories, establishing 2-3 cases per day for each market covered (up to 6 markets)
- Affirms attendance on all health plan and local calls
- Calls in for weekly Primary Care Provider (PCP) and Skilled Nursing Facility (SNF) meetings covering the assigned territories
- Advises other physician reviewers
- Participates in Process and Quality Improvement initiatives related to Delegated Utilization Management
Requirements
- Graduate from an accredited Medical School with a valid, unrestricted license
- Completion of Internal Medicine or Family Practice residency
- Board Certification in residency area - Orthopedics preferred
- Two (2) years’ experience in Hospital medicine preferred
- At least one (1) year of utilization review experience preferred
Qualifications
- Excellent analytical and deductive reasoning skills
- Good judgment 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
Skills
- Knowledge of healthcare regulations and policies
- Ability to manage multiple tasks and prioritize effectively
- Strong interpersonal and collaboration skills
Benefits
We offer competitive compensation, comprehensive benefits, career development and advancement opportunities, and a supportive work environment that values employee well-being. Join us and make a difference in people's lives every day.
For current employees interested in applying to our internal career site, please click HERE. For contingent workers interested in applying, please see the job aid HERE.