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. 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 ( Current Contingent Worker please see job aid HERE to apply #LI-Remote ChenMed

Job Tags

Work at office, Local area,

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