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Remote Physician Reviewer — Utilization & Care Quality

ChenMed LLC

New York, NY
  • Remote job

ChenMed LLC is seeking a Physician Reviewer to lead delegated utilization management (UM) reviews across multiple markets. You will establish daily case counts, attend essential calls with health plans, advise other reviewers, and participate in ongoing process and quality improvements. A strong medical background with licensure and board certification is required. Two years in hospital medicine and at least one year in utilization review are preferred, with excellent analytical and #J-18808-Ljbffr ChenMed LLC

Vacancy posted 1 day ago
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