Licensed Physician Reviewer – Endocrinology
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Job Description
Physician reviewer handling delegated utilization management, territory calls, and care coordination for ChenMed’s senior healthcare patients. Advising reviewers and improving UM quality processes.
Responsibilities:
- Serve as the primary physician reviewer for Utilization Management cases
- Provide Delegated UM for assigned territories, establishing 2–3 cases per day for each market covered, up to 6 markets
- Attend all health plan and local calls
- Participate in weekly Primary Care Provider and Skilled Nursing Facility meetings for assigned territories
- Advise other physician reviewers
- Coordinate care for patients
- Participate in Process and Quality improvement for Delegated Utilization Management
- Perform other duties as assigned and modified by the 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 Microsoft Office products such as Outlook, Excel, Word and PowerPoint
Benefits:
- Comprehensive benefits
- Career development and advancement opportunities
- Great work-life balance
- Bonuses or commissions may be available
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