Licensed Physician Reviewer – Radiology

🔥 39 minutes ago

🇺🇸 United States – Remote

💵 $204.8k - $292.5k / year

⏱ Part Time

🟢 Junior

🟡 Mid-level

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ChenMed

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1970

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Healthcare Insurance • Healthcare • Pharmaceuticals

ChenMed is America’s leading primary care provider focused on delivering preventive, VIP care for seniors. The company prioritizes the doctor-patient relationship, offering a personalized and intensive care model where physicians manage smaller patient panels, enhancing the quality of care. With around-the-clock access to doctors, on-site medications, and transportation assistance, ChenMed aims to improve health outcomes for vulnerable elderly populations, emphasizing prevention and relationship-building in healthcare.

📋 Description

• Primary physician reviewer for Utilization Management (UM) cases in the organization • Advising other physician reviewers and attending daily calls with health plan teams • Assisting with care coordination for patients • Participating in Process and Quality improvement in Delegated Utilization Management area • Establishing 2-3 cases a day for each market covered (up to 6 markets) • Ensuring attendance on all health plan and local calls • Calling in for weekly Primary Care Provider (PCP) and Skilled Nursing Facility (SNF) meetings covering the assigned territories • Other duties as assigned and modified by manager

🎯 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 • 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 • Work-life balance