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Remote Physician Reviewer - Utilization Management

ChenMed

Miami, FL
  • Remote job

ChenMed is seeking a Physician Reviewer to lead utilization management reviews and advise fellow physicians. The role includes coordinating care with health plans and local teams, participating in QA and delegated UM processes, and supporting territory-based case development. Strong analytical skills, English fluency, and MS Office proficiency are essential. Qualified candidates are MDs with Internal Medicine or Family Practice training, board certification, and hospital medicine experience #J-18808-Ljbffr ChenMed

Vacancy posted 3 days ago
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