[Hiring] Licensed Physician Reviewer - Ortho @LE040 ChenMed, LLC

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Role Description

The Physician Reviewer is the primary physician reviewer for Utilization Management/Clinical Appropriateness review cases in our organization.

  • 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

Qualifications

  • 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

Requirements

  • 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

Benefits

  • Great compensation
  • Comprehensive benefits
  • Career development and advancement opportunities
  • Great 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.

  • Our vision: To positively change American healthcare through primary care innovation for the neediest populations.
  • Our mission: To provide a convenient, patient-centered environment that fosters enduring relationships between doctors, staff and patients and delivers superior outcomes and a compassionate experience.
  • Our patient promise: You are the reason we are here. Your coordinated healthcare and well-being is our focus.
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