Licensed Physician Reviewer - Ortho (remote) at ChenMed Miami, FL

Position: Licensed Physician Reviewer – Ortho (remote) – ChenMed, Miami, FL The Physician Reviewer is the primary reviewer for Utilization Management/Clinical Appropriateness cases within our organization. The role requires advising other physician reviewers, attending daily calls with health plan teams and local teams, and coordinating patient care. Additionally, the reviewer participates in process and quality improvement efforts related to Delegated Utilization Management. ESSENTIAL JOB DUTIES / RESPONSIBILITIES Provide 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). Ensure attendance on all health plan and local calls. Participate in the weekly Primary Care Provider (PCP) and Skilled Nursing Facility (SNF) meetings covering the assigned territories. Advise other physician reviewers as needed. Perform other duties as assigned and modified by manager. KNOWLEDGE, SKILLS AND ABILITIES Excellent analytical and deductive reasoning skills. Good judgment and problem‑solving skills. Professional and effective communication skills. Strong organizational skills. Written and verbal fluency in English. Proficiency in Microsoft Office products such as Outlook, Excel, Word and PowerPoint. EDUCATION AND EXPERIENCE CRITERIA Graduate from an accredited medical school with a valid, unrestricted license. Completion of an Internal Medicine or Family Practice residency. Completion of an Orthopedic Surgery fellowship. Board certification in residency. Board certification in Orthopedic Surgery. At least two years of experience in hospital medicine (preferred). At least one year of utilization review experience (preferred). BENEFITS Great compensation, comprehensive benefits, career development and advancement opportunities, and a strong commitment to work‑life balance. #J-18808-Ljbffr ChenMed