Title: Licensed Physician Reviewer-GI (remote)

Location: Miami, FL (Remote)

Specialties: Gastroenterology, Internal Medicine, Family Medicine

Summary

The physician reviewer is responsible for clinical appropriateness reviews across multiple markets, advising other physician reviewers, participating in health plan and local team calls, and contributing to process and quality improvement in delegated utilization management. The role requires an MD with completed residency in Internal Medicine or Family Practice, Gastroenterology fellowship, board certifications, and utilization review experience.

Added on: 07/19/2025

Full 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

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 Employee apply HERE

Current Contingent Worker please see job aid HERE to apply