Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Licensed Physician Reviewer

$204.76k - $292.52k

ChenMed

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 Infectious Disease
  • Two (2) years' experience in Hospital medicine preferred
  • At least one (1) year of utilization review experience preferred

PAY RANGE:
$204,761 - $292,515 Salary
The 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
Vacancy posted 20 hours ago
Similar jobs that could be interesting for youBased on the Licensed Physician Reviewer in United States vacancy
  • $204.76k - $292.52k

     ...expanding and we need great people to join our team. The Physician Reviewer is the primary physician reviewer for Utilization Management...  ...Graduate from accredited Medical School with a valid, unrestricted license is required Completion of Internal Medicine or Family... 
    Suggested
    Hourly pay
    Full time
    Work at office
    Local area
    Remote work

    ChenMed

    Miami, FL
    20 hours ago
  •  ...position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Licensed Physician Reviewer based in United States. As a Licensed Physician Reviewer, you will serve as a primary physician reviewer for... 
    Suggested
    Full time
    Local area
    Remote work

    jobgether

    United States
    6 days ago
  • 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 Louisiana License to address the medical necessity of... 
    Suggested
    Extra income
    Contract work
    Remote work

    Dane Street, LLC

    Louisiana, MO
    1 day ago
  • Overview Dane Street is an Independent Review Organization and a national provider of Utilization...  ...other offerings). We are expanding our physician panel, resulting in opportunities for...  ...listed below with active Louisiana License to address the medical necessity of... 
    Suggested
    Extra income
    Contract work
    For contractors
    Remote work

    Dane Street, LLC

    Louisiana, MO
    5 days ago
  • $29.29 - $50.38 per hour

     ...Outpatient Community Services will serve as the Licensed Practitioner of the Healing Arts (LPHA)...  ...Treatment Plans. Will complete thorough review of each document, provide clinical...  ...with community agencies, primary care physicians, court system, and managed-care entities... 
    Suggested
    Full time
    Local area
    Immediate start
    Relocation
    Relocation package
    Shift work

    Carle Health

    Peoria, IL
    3 days ago
  •  ...Job Description Job Description Physician Peer Reviewer – Multiple Specialties in Texas and/or New Mexico Overview Federal Hearings and Appeals...  ...FHAS is currently expanding its elite panel of physicians licensed in the state of TEXAS or NEW MEXICO to assist with independent... 
    Contract work
    Work experience placement
    Work at office
    Remote work

    Federal Hearings And Appeals

    Wilkes Barre, PA
    7 days ago
  •  ...Hours: Mon-Fri Core business hours 40hr/week Overview As a Physician Reviewer, you'll play a critical role in ensuring that our members receive...  ...Certified (ABMS) M.D. or D.O., unrestricted and active license to practice medicine 5 years clinical experience, including... 

    EPITEC

    Nashville, TN
    3 days ago
  •  ...Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide accurate coverage determinations for inpatient and...  ..., at the right time. The role requires an active US medical license, MD/DO degree, and 3–5 years of primary care experience,... 
    Full time
    Remote work

    Oak Street Health

    Richmond, VA
    1 day ago
  •  ...A leading independent review organization is seeking a Utilization Management Physician Reviewer for a full-time remote role. Candidates must possess an active Nebraska medical license and have a minimum of 5 years clinical practice experience. Responsibilities include... 
    Full time
    Casual work
    Remote work
    Monday to Friday

    ExamWorks UM Strategies

    New York, NY
    1 day ago
  •  ...Physician Reviewer OpportunityWe are seeking a Physician Reviewer to join our team at Independent Living Systems (ILS). ILS, along with its...  ...accredited institution.Active and unrestricted Florida medical license.Minimum of 3 years clinical experience in a managed care... 

    Independent Living Systems LLC

    Miami, FL
    3 days ago
  •  ...A leading Independent Review Organization is seeking a Board-Certified Physical Medicine and Rehabilitation...  ...must possess an active New York medical license and Workers’ Compensation Board Certification. Apply to join our Physician Review Panel and start earning based on your... 
    Extra income
    Remote work
    Flexible hours

    Dane Street

    United States
    1 day ago
  •  ...Certified Physical Medicine & Rehabilitation (PM&R) physicians in Michigan to join their panel of independent reviewers. This fully remote consultant role allows...  ...experience post-residency and a current Michigan medical license, with a strong expertise in PM&R,... 
    For contractors
    Remote work

    Dane Street

    Lansing, MI
    3 days ago
  •  ...A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or DPM degree with active board certification and unrestricted medical license in relevant states. The role involves performing detailed... 
    Full time
    Remote work
    Work from home

    ExamWorks

    New York, NY
    1 day ago
  •  ...seeking board-certified Pain Management Physicians for fully remote Physician Consultant positions...  .... As a URAC accredited Independent Review Organization, our physicians perform...  ...requiring an active, unrestricted physician license and effective communication skills.... 
    For contractors
    Remote work

    ezURs Inc

    Richardson, TX
    3 days ago
  •  ...Physician ReviewerLocation: 100% RemoteDuration: 2+ Years Contract Position+ Contract to...  ...computer to perform work.Physician medical reviewers evaluate clinical service requests based...  ...) M.D. or D.O, unrestricted and active license to practice medicine requested and 5 years... 
    Contract work
    Remote work

    Careers Integrated Resources Inc

    Chicago, IL
    3 days ago
  • A national provider of utilization review services is seeking independent contract reviewers to provide telework opportunities for physicians. Candidates must hold a current New York medical license and be Workers Comp Board Certified. The role allows flexibility in scheduling... 
    Contract work
    Remote work

    Dane Street

    California, MO
    4 days ago
  •  ...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

    Dane Street

    United States
    3 days ago
  •  ...Clinical Services Reviewer Can work remotely in any state except CA, NY, HI or AK 20...  ...clinical service requests. Participates in the Physician Review Units' appeal process of service...  ...) M.D. or D.O, unrestricted and active license to practice medicine requested and 5... 
    Remote work
    Weekend work

    Mindlance

    Chicago, IL
    4 days ago
  •  ...Summary: We are seeking a highly experienced DRG Clinical Physician Reviewer to join our growing clinical review team. This is a fully...  ...Qualifications: ~ MD/DO required with active, unrestricted U.S License ~ Board Certification required (ABMS or AOA) ~5+ years of... 
    Remote work

    Med Review Inc

    New York, NY
    3 days ago
  •  ...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

    Vytwo

    Prosper, TX
    20 hours ago
  •  ...Remote 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]. Seeking...  ...Certified, M.D. or D.O with an unrestricted physician license in a state or territory of the United States.- Must... 
    Work at office
    Remote work
    Monday to Friday
    Shift work
    Weekend work
    3 days per week

    Mindlance

    Chicago, IL
    3 days ago
  •  ...searching for Board Certified Internal Medicine physicians to conduct Independent Medical Exams (IME) and Peer Reviews. This opportunity allows you to customize your...  ...time Maintains proper credentialing and state licenses and any special certifications or requirements... 
    For contractors
    Monday to Friday

    Dane Street

    Chicago, IL
    3 days ago
  •  ...Neurosurgeon, Neurologist, and Physical Medicine & Rehabilitation physician to process utilization reviews. Work's Compensation experience is preferred but not...  ...will hold a CA, GA, FL, IL, KY, LA, NV, or TX license. Job Summary Utilizes clinical expertise, and reviews... 
    For contractors
    Remote work
    Monday to Friday

    Dane Street

    Washington DC
    4 days ago
  • $130 - $145 per hour

     ...Hi, we're Oscar. We're hiring a Behavioral Health Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance...  ...as a psychiatrist. - MD or DO with a current unrestricted license to practice medicine in the US, and willing to obtain... 
    Hourly pay
    Full time
    Part time
    Remote work
    Work from home
    Home office

    Oscar

    New York, NY
    2 days ago
  • $140 - $145 per hour

     ...Description Job Description Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management Team. Oscar is the...  ...Requirements: ~ Board certification as an MD or DO ~ Licensed in one of these states: FL, NC, AZ OR possess an active Interstate... 
    Hourly pay
    Full time
    Part time
    Local area
    Remote work
    Work from home
    Home office
    Weekend work

    Oscar Health

    New York, NY
    4 days ago
  • $5,098.66 - $8,304.83 per month

     ...DSHS opportunities for early career pathways, visit the DSHS Careers Page. Review our Top 10 Tips for Success when Applying to State of Texas Jobs. Functional Title: Radioactive Materials License Reviewer Job Title: Health Physicist I Agency: Dept of State Health... 
    Full time
    Temporary work
    Part time
    Work at office
    Remote work
    Shift work
    Day shift

    Texas Department of State Health Services

    Austin, TX
    1 day ago
  •  ...Peer experience Preferred but not required. JOB SUMMARY As a Physician Reviewer/Advisor for Disability Peer Review, you will utilize...  ...in Otolaryngology Current, unrestricted New Mexico Medical License 5+ years of clinical practice experience Attends all required... 

    Dane Street, LLC

    Santa Fe, NM
    4 days ago
  • Dane Street is seeking physicians to join our independent contractor reviewer panel. This telework opportunity involves evaluating medical necessity for treatment...  ...must hold a current, unrestricted Colorado medical license, be actively practicing, and board certified.... 
    Remote job
    For contractors
    Flexible hours

    Dane Street, LLC

    Brooklyn, NY
    1 day ago
  • PHYSICIAN REVIEWER Independent Medical Review | Remote Opportunity Organization : Christopher Place Healthcare Review (CPHCR) Location :...  ...requirements. Minimum Qualifications Current, unrestricted medical license in the physician's state of practice. Current board... 
    Remote job
    Flexible hours
    Weekend work
    Weekday work

    Tadalafil Easy Buy

    Brooklyn, NY
    2 days ago
  • Overview Dane Street wants you to join our dynamic team of expert reviewers! In this role, you will have the opportunity to utilize your...  ...Requirements Board Certified in Current, unrestricted Medical License 5+ years of clinical practice experience Attends all required orientation... 
    For contractors
    Remote work

    Dane Street

    Washington DC
    3 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Licensed Physician Reviewer. Be the first to apply!