Physician Reviewer

• 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.

Physician Reviewer for Utilization Management cases in remote position

Licensed Physician Reviewer – Dermatology

Physician Reviewer handling Utilization Management cases remotely. Advising physician reviewers, attending health plan meetings, and coordinating patient care.

• 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.

Licensed Physician Reviewer for Utilization Management in a remote capacity

Licensed Physician Reviewer – Pulmonology

Licensed Physician Reviewer handling Utilization Management cases remotely. Improving healthcare quality and advising physician reviewers in an expanding organization.

• 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

Licensed Physician Reviewer for Utilization Management cases

Licensed Physician Reviewer – Otorhinolaryngology (ENT) PRN

Licensed Physician Reviewer responsible for advising other physician reviewers in Utilization Management. Join ChenMed to transform healthcare for seniors in a rapidly expanding team.

Physician Reviewer managing Utilization Management cases for healthcare provider

Licensed Physician Reviewer – Infectious Disease

Physician Reviewer managing Utilization Management cases in a remote setting. Advising physician reviewers and coordinating patient care with healthcare teams.

• 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

Physician Reviewer managing Endocrinology cases for Utilization Management

Licensed Physician Reviewer – Endocrinology

Physician Reviewer for Endocrinology handling Utilization Management cases. Advising other physician reviewers and coordinating care for patients as part of a transformative healthcare organization.

• 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.

Physician Reviewer managing utilization management for healthcare organization

Licensed Physician Reviewer – Rheumatology

Physician Reviewer in Utilization Management for ChenMed. Analyzing cases, advising teams, and improving processes for quality healthcare delivery.

• 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
• Advises other physician reviewers
• Other duties as assigned and modified by manager

Physician Reviewer overseeing Utilization Management for healthcare organization

Licensed Physician Reviewer – Orthopedics

Physician Reviewer managing Utilization Management cases in a rapidly expanding healthcare organization. Collaborating with teams to improve the care for patients and involve in quality improvement.

• 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

Primary Physician Reviewer for Utilization Management cases in healthcare organization

Licensed Physician Reviewer – Neurology

Primary Physician Reviewer overseeing UM cases in a healthcare organization. Collaborating with physician reviewers, health plan teams, and participating in quality improvement initiatives.

• Primary physician reviewer for Utilization Management (UM) cases in the organization
• Advising other physician reviewers and attending daily calls with health plan teams
• Assisting with care coordination for patients
• Participating in Process and Quality improvement in Delegated Utilization Management area
• Establishing 2-3 cases a day for each market covered (up to 6 markets)
• Ensuring attendance on all health plan and local calls
• Calling in for weekly Primary Care Provider (PCP) and Skilled Nursing Facility (SNF) meetings covering the assigned territories
• Other duties as assigned and modified by manager

Physician Reviewer overseeing utilization management cases remotely

Licensed Physician Reviewer – Radiology

Physician Reviewer overseeing utilization management cases in remote healthcare setting. Collaborating with teams to improve patient care and quality while managing multiple cases and responsibilities.

• Primary physician reviewer for Utilization Management (UM) cases in our organization
• Advise other physician reviewers
• Attend daily calls with health plan teams and local teams assisting with this function
• Coordinate care for patients
• Participate in Process and Quality improvement in Delegated Utilization Management
• Establish 2-3 cases a day for each market covered (up to 6 markets)
• Ensure attendance on all health plan and local calls
• Call in for weekly Primary Care Provider (PCP) and Skilled Nursing Facility (SNF) meetings covering the assigned territories

Licensed Physician Reviewer - Urologist for Utilization Management cases

Licensed Physician Reviewer – Urologist

Licensed Physician Reviewer - Urologist handling UM cases and advising other reviewers. Engaging in quality improvement and communication with health plan teams while ensuring patient care coordination.

• Be the primary physician reviewer for Utilization Management (UM) cases in our organization
• Advise other physician reviewers and attend daily calls with health plan teams
• Coordinate care for patients
• 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 Process and Quality improvement in Delegated Utilization Management

Physician Reviewer for Ophthalmology overseeing Utilization Management cases at ChenMed

Licensed Physician Reviewer, Ophthalmology

Physician Reviewer for Ophthalmology at ChenMed, responsible for overseeing Utilization Management cases and advising on medical care. Collaborates in process and quality improvement initiatives.

• Evaluate and review disability claims from home
• Participate as part of an independent physician panel of contract reviewers with flexible scheduling
• Focus on clinical decision-making without establishing a doctor/patient relationship

Board Certified Physician reviewing disability claims remotely for Dane Street

Board Certified Disability Peer Physician Reviewer – Gastroenterology

Board Certified Physician reviewing disability claims for Dane Street. Enjoy flexible scheduling as part of the independent peer review team from home.

• Evaluate and review disability claims
• Telework opportunity from the convenience of home
• Join an independent physician panel of contract reviewers (1099)
• Enjoy flexible scheduling

Board Certified Physicians evaluating disability claims for telework opportunity

Board Certified Disability Peer Physician Reviewer – Hematology

Board Certified Physicians evaluating and reviewing disability claims from home. Join our independent panel for flexible scheduling as a Disability Peer Reviewer.

• Evaluate and review disability claims
• Conduct work from the convenience of home
• Enjoy flexible scheduling and balance work with lifestyle

Disability Peer Review Physician evaluating medical claims for Dane Street

Board Certified Cardiology Disability Peer Reviewer

Disability Peer Review Physician evaluating and reviewing disability claims for Dane Street. Flexible remote work with no patient treatment involved.

• Utilize medical expertise to conduct thorough reviews of clinical cases
• Evaluate medical records and provide clinical summaries
• Engage in peer communications and answer specific questions posed by clients

Utilize medical expertise to conduct clinical case reviews as a physician

Board Certified Allergy Immunology Physician – Disability Peer Reviewer

Join Dane Street as a Board Certified Allergy Immunology Physician conducting clinical case reviews. This remote role allows flexibility as a 1099 independent contractor.

• Conduct independent, remote case reviews evaluating medical necessity, appropriateness, or quality of care.
• Provide evidence-based assessments and written determinations following established clinical guidelines and review criteria.
• Support case types including Utilization review, Appeals and hearings, Quality of care and standard of care concerns.
• Uphold the highest standard of clinical integrity, neutrality, and objectivity.

Physician Peer Reviewer conducting remote evaluations of care quality and necessity

Physician Peer Reviewer – actively practicing

Physician Peer Reviewer conducting remote case reviews for medical necessity and quality of care. Supporting veterans with data-driven evaluations and maintaining clinical integrity while working independently.

Physician Reviewer jobs in United States

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