US National – Telecommute
Associate Medical Director – Medical Oncology (100% Remote)
Career Locations: US-Remote
Career ID: 2019-5982
Career Category: Clinical
The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in a clinical specialty recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the past 18 months).
Have at least 5 years of clinical experience (post-residency/fellowship
Knowledge of applicable state and federal laws, URAC and NCQA standards a plus, and familiarity with automated processes and computer applications and systems is required
Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.
Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.
Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.
Documents all actions related to clinical review sessions and attests to appeal review qualifications as required.
Maintains files of all reviews as required by law and Health Plans to retrieve reportable data.
Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications.
Supports the annual review of utilization review criteria.
Supports and communicates eviCore policy and procedures to the provider community.
Participates in strategic planning for and evaluation of the Care Management process/unit.
Assists with staff educational training and in-service programs and serves as a clinical resource for eviCore staff.
eviCore is committed to hiring and retaining a diverse workforce. We are an Equal Opportunity Employer, making decisions without regard to race, color, religion, sex, national origin, age, veteran status, disability, or any other protected class. Applicants must be able to pass a drug test and background investigation
Our Company and What We Offer
eviCore healthcare is committed to making a positive impact on healthcare, and also making a positive impact on our employees. eviCore offers a variety of perks and benefits including, but not limited to:
Flexible scheduling and work/life balance with remote and work from home opportunities
4 weeks of PTO(starting) per year plus paid holidays
Education assistance, tuition reimbursement and professional certifications
Health, dental, vision, and life benefits with employer funded HSA
Comprehensive employee discount program, onsite fitness facilities, and smart casual dress code
Paid Volunteer Community Service Days
Ample opportunities for growth, advancement, and promotion
401k retirement plan with company match of 50% employee contributions up to 6%
Apply for this position online
eviCore healthcare is committed to hiring and retaining a diverse workforce. We are an Equal Opportunity Employer, making decisions without regard to race, color, religion, sex, national origin, age, veteran status, disability, or any other protected class. Applicants must be able to pass a drug test and background investigation.
Healthcare Consultant , Medical & Health , Doctor & Practitioner , Operations