Key Facts

Remote From:

Part time

Mid-level (2-5 years)

English

Hard Skills

Clinical Data Analysis Case Management Systems Gastroenterology Utilization Management Care Coordination Quality Assessment Utilization Management Care Management Clinical Governance Process Improvement +2 more

Other Skills

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Microsoft Excel
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Microsoft PowerPoint
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Microsoft Word
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Microsoft Outlook
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Professional Communication
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Non-Verbal Communication
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Organizational Skills
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Analytical Thinking
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Deductive Reasoning
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Problem Solving

Roles & Responsibilities

Graduate from accredited Medical School with a valid, unrestricted license
Completion of Internal Medicine or Family Practice residency
Fellowship in Gastroenterology with Board Certification in Gastroenterology
Two years of hospital medicine experience and at least one year of utilization review experience (preferred)

Requirements:

Provide Clinical Appropriateness Reviews for assigned territories, establishing 2-3 cases per day per market (up to 6 markets) and ensuring attendance on all health plan and local calls, including PCP and SNF meetings
Advise other physician reviewers and participate as the primary reviewer for Clinical Appropriateness Reviews; attend daily calls with health plan teams and local groups to coordinate care
Participate in process and quality improvement initiatives in the delegated utilization management area
Perform other duties as assigned by the manager

ChenMed

Medical Device

About ChenMed

We’re on a mission. To change lives. And to change healthcare. ChenMed serves underserved – moderate-to-low-income seniors with complex chronic diseases. Our high-touch, VIP, preventive primary care works. For our patients. And our team members. Unlike typical primary care providers, we have a much lower doctor-patient ratio which allows us to spend more time with our patients, getting to know them and their concerns so we can better serve them. Practicing medicine, the way it was meant to be practiced. We are known to our patients as Dedicated Senior Medical Center, Chen Senior Medical Center, or JenCare Senior Medical Center. With 100+ centers in 15 states, our privately held, physician-led company is featured in Fortune’s 2020 “Change The World” list, listed as a “Great Places To Work” 2022, 2023, and listed as one of Newsweek's "Most Loved Places to Work" for 2021 and 2022. We offer competitive compensation/benefits, a great mission-driven culture and so much more.

Company type: Large

Industry: Medical Device

Founded: 2018

Company size: 1001 - 5000

Website LinkedIn See all jobs →

Job description

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 Clinical Appropriateness Reviews 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 Clinical Appropriateness Reviews 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
Completion of Fellowship in Gastroenterology
Board Certification in residency area
Board Certification in Gastroenterology
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

https://chenmed.makeityoursource.com/helpful-documents

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

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