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
Football - Head CoachJob Goal: To train athletes to compete individually or as a team, and to provide assistance to the athletes to develop their full potential.Qualifications:All candidates must possess appropriate N.J. State Certification.Available to work during...
...and Shanghai.We are seeking a highly organized Operations Business Analyst to support the firms Operations and Global teams. The role... ...and confidentiality.Preferred Qualifications Coursework or internship experience related to accounting operations or data analytics...
...Job Description Job Description WE ARE LOOKING FOR CLEANERS! Looking for a flexible schedule - we can give you one! Please be... ...training from day one Great opportunity for advancement Great office support Paid weekly- direct deposit available All...
...Medical Center offers a total rewards package that supports the health, life, career and retirement of our colleagues. The... ...What Qualifications You Will Need: Bachelor's degree in laboratory scienceor related sciencerequiredOR Grandfathered as a medical...
...coastal community. Enjoy a fulfilling career as you support the health of our patients and a team focused on excellence. Benefits... ...Tech NIH - Stroke Certification Education ~ Associates degree preferred Entry USD $33.78/Hr. Max...