Licensed physician Reviewer
$204.76k - $292.52kChenMed
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 (UM) 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 UM 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
- Board Certification in residency area
- Two (2) years’ experience in Hospital medicine preferred
- At least one (1) year of utilization review experience preferred
PAY RANGE:
$204,761 - $292,515 SalaryThe posted pay range represents the base hourly rate or base annual full-time salary for this position. Final compensation will depend on a variety of factors including but not limited to experience, education, geographic location, and other relevant factors. This position may also be eligible for a bonuses or commissions.
EMPLOYEE BENEFITS
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 employees, if you want to apply to our internal career site, please click HERE
Current Contingent Worker please see job aid HERE to apply
#LI-Remote- ...process to evaluate clinical service requests. Participates in the Physician Review Units' appeal process of service denials. Participates in the... ...Board Certified (ABMS) M.D. or D.O, unrestricted and active license to practice medicine requested and 5 years clinical...SuggestedRemote workWeekend work
- ...Physician Peer Reviewer - Multiple Specialties in Texas and/or New Mexico Overview Federal Hearings and Appeals Services (FHAS... ...FHAS is currently expanding its elite panel of physicians licensed in the state of TEXAS or NEW MEXICO to assist with...SuggestedContract workWork experience placementWork at officeRemote work
$100 per hour
...looking for US-based, actively practicing physicians (MD/DO) to evaluate clinical EHR... ...and an active, unrestricted US medical license (verified with the issuing medical board... ...evaluation, clinical content or exam-question review, or medical annotation/QA (a plus); Strong...SuggestedHourly payPermanent employmentPart time10 hours per week$219k - $286.9k
...Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built... ...: ~ Board certification as an MD or DO ~ Licensed in one of these states: FL, NC, AZ OR possess an active Interstate...SuggestedFull timeLocal areaRemote workWork from homeHome officeWeekend work$230k
...Company: Oak Street Health Title: Utilization Management Physician Reviewer Location: Fully Remote Hours: Full-Time, Monday -... ...communication skills ~ A current, clinical, unrestricted license to practice medicine in the United States. (NCQA Standard)...SuggestedHourly payFull timeLocal areaRemote workMonday to Friday- ...Dane Street wants you to join our dynamic team of expert reviewers! In this role, you will have the opportunity to utilize your medical... ...Requirements ~ Board Certified ~ Current, unrestricted Medical License ~5+ years of clinical practice experience ~ Attends all...For contractorsRemote work
- ...Role: Physician ED Claims Reviewer Duration: 12 months Required skills: Physician with an active US licensed with experience in with medical coding (CPT/HCPCS) and managed care to conduct clinical review of claims and UM authorization requests for clinical necessity...Remote work
- ...Dane Street is an Independent Review Organization and a national provider of Utilization... ...offerings) and we are expanding our physician panel resulting in opportunities for non... ...specialties listed below with active New York license and Workers Comp Board Certified to...Extra incomeContract workRemote work
- ...a certified “Great Place to Work” company is seeking a Physician to provide utilization review services for the Group Health Department. This role... ...to clients. Maintain proper credentialing, state licenses, and any special certifications Utilize current criteria...Remote work
- ...Remote Weekend Physician Medical ReviewerPre-service reviews only. Training will be for 3-4 days per week for at least 4 weeks, Monday - Friday 8a-5pm (CST... ...certified, M.D. or D.O with an unrestricted physician license in a state or territory of the United States. - Must...Work at officeRemote workMonday to FridayShift workWeekend work3 days per week
- ...medical appropriateness of inpatient and outpatient services by reviewing clinical information and applying evidence-based guidelines.... ...duties as assigned Requirements Board-certified MD or DO Licensed in Florida or North Carolina and/or eligible for or active...Remote workWeekend work
- ...DRG Clinical Physician Reviewer We are seeking a highly experienced DRG Clinical Physician Reviewer to join our growing clinical review... ...Qualifications: ~ MD/DO required with active, unrestricted U.S License ~ Board Certification required (ABMS or AOA) ~5+ years of...Remote work
- ...About MMRO Managed Medical Review Organization (MMRO) is a nationally recognized, URAC... ...the expertise of experienced practicing physicians. MMRO is committed to integrity,... ...Required Current, unrestricted M.D. or D.O. license to practice medicine in the United...Full timeContract workFor contractorsRemote workFlexible hours
$91.7k - $163.7k
...healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together. The Licensed Psychologist, Peer Reviewer for Applied Behavior Analysis (ABA) Services evaluates requests for initial and continued coverage of ABA treatment...Minimum wageFull timeWork experience placementLocal areaRemote work$65 - $90 per hour
...Remote Commitment: 10 hours/week Role Responsibilities Review and evaluate written content and AI-generated responses in... ...~ Degree-qualified architect with a professional architecture license in the US. ~2+ years of professional architecture experience...Contract workSummer workRemote work10 hours per week$80 - $130 per hour
...looking for US-based, actively practicing physicians (MD/DO) to evaluate clinical EHR... ...and an active, unrestricted US medical license (verified with the issuing medical board... ...evaluation, clinical content or exam-question review, or medical annotation/QA (a plus); Strong...Permanent employmentContract workTemporary workPart timeFreelanceRemote work10 hours per week$52 - $56 per hour
...grievances and appeals end to end: intake, investigation, clinical review, decision and notification • Apply medical necessity... ...What you need: • Active, unrestricted New York State RN license (compact alone does not qualify) • 3+ years of RN experience...Remote jobContract workAfternoon shift$60.88k - $79.56k
...quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital... ...coding and documentation improvement areas to leadership to review and respond. Reviews and responds to requests for coding and documentation...Full timeTemporary workPart timeRemote workFlexible hours$262k - $278.5k
...expand and transform the primary care experience, we're seeking physicians to deliver exceptional virtual primary care. In this role, you... ...oversight of 4-8 NP or PA colleagues Education, licenses and experience required for this role: ~ Completed an accredited...Full timeTemporary workWork at officeRemote workAfternoon shift- ...A leading healthcare consulting firm is seeking a Specialty Physician Reviewer with expertise in genetics to conduct thorough reviews and provide peer consultations. This flexible contract role requires an MD or DO degree and board certification in relevant specialties...Contract workRemote workFlexible hours
- ...About DevotedDOc DevotedDOc is a physician-led virtual medical group expanding access to... ...currently practicing telemedicine, hold licenses in multiple states, and are comfortable... ...applicable federal and state requirements Review medical histories, prescription...Contract workWork at officeRemote workFlexible hours
- ...Dane Street wants you to join our dynamic team of expert reviewers! In this role, you will have the opportunity to utilize your medical... ...in Infectious Disease ~ Current, unrestricted Indiana Medical License ~5+ years of clinical practice experience ~ Attends all required...Contract workFor contractorsRemote work
- ...Wheel Medical Group is seeking physicians to join our network of world-class clinicians delivering... ...must have at least 40 active state licenses to be eligible for this role. About... ...asynchronous and synchronous virtual care. Review comprehensive patient intake information...Full timeContract workPart timeWork at officeRemote workFlexible hoursShift workWeekend workAfternoon shift
- ...Makes This Opportunity Unique \n \n Join a mission-driven physician team focused on improving patient outcomes during a pivotal time... ...You Should Bring \n \n MD or DO with an active medical license in all 40+ U.S. states (Near-50-state licensure is ideal, but not...Remote jobContract workFlexible hours
$262k - $278.5k
...expand and transform the primary care experience,we'reseeking physicians to deliver exceptional virtual primary care. In this role,you'... ...setting BoardCertifiedinInternalor Family Medicine Active state license in either CA,NYor DC Minimum of 15 state licenses and...Full timeTemporary workWork at officeRemote workAfternoon shift- ...Role Title: US-Licensed Physician Internal Medicine Role Type: Contractor Location: Remote United States Job Summary We are seeking experienced Internal Medicine physicians to review inpatient medical records and documentation for AI training. The role...Full timeFor contractorsRemote work
- ...accomplished Board Certified Orthopedic Surgeon physician? Are you passionate about your work/life balance?... ...independent contractor. Candidates must have a MS license. JOB SUMMARY: Relying on clinical background, reviews health claims providing medical interpretation and...Temporary workFor contractorsLocal areaRemote workMonday to FridayFlexible hours
$211k - $225k
...Full time The Opportunity We are seeking a Primary Care Physician to join our team in a unique remote role. This is a fully virtual... ..., achieving schedule utilization benchmarks Education, Licenses, and Experiences Required Enrolled in, or have completed, an...Full timeTemporary workWork at officeLocal areaRemote workWeekend workAfternoon shift$90k - $105k
...part of the Complex Payment Solutions Team, you will, as a DRG Reviewer, be a key contributor responsible for conducting thorough DRG payment... ...in lieu of formal education at leadership discretion. License / Certification (at least one of the following is required)...Full timeContract workWork experience placementFlexible hours- ...Overview Our Utilization Management Reviewers evaluate medical necessity for inpatient... ...Identify and escalate complex cases requiring physician review or additional intervention... ...Active and unencumbered Registered Nurse license required Active and unencumbered Nurse...Remote workMonday to FridayFlexible hoursWeekend work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Licensed physician Reviewer. Be the first to apply!
- supervising physician Remote
- sports medicine physician Remote
- internal medicine primary care physician Remote
- doctor work from home Remote
- utilization review physician Remote
- primary care physician Remote
- resident doctor Remote
- post-acute care physician Remote
- preventive medicine physician Remote
- anesthesia physician Remote







