Associate Medical Director - Rheumatology - Work from home - eviCore
Company: eviCore Healthcare
Location: Melbourne
Posted on: April 6, 2021
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Job Description:
Rheumatology opening in Melbourne, Florida. This and other
physician jobs brought to you by DocCafe.com Job
DescriptionThinking about joining eviCore as an Associate Medical
Director? --Working at eviCore allows you to make a difference in
people's lives by improving the quality of their healthcare. As an
Associate Medical Director, you will feel intellectually stimulated
and challenged, and you will be empowered by the difference you are
making on a more global level in healthcare.Additional advantages
of working at eviCore as an Associate Medical Director include:-
Predictable work schedules: No nights, no weekends, no call- 100%
Remote full-time opportunity- Salaried position with benefits- The
ability to impact healthcare on a larger scale--- Supportive
organization with collaborative culture: Hands-on training provided
in our Melbourne, FL office (currently training is being conducted
remotely)Responsibilities:- 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 necessary credentials and immediately informs eviCore of
any adverse actions relating to medical licenses and/or board
certifications.- Participates in strategic planning for and
evaluation of the Care Management process/unit. --Minimum
Requirements:------------------------------- The successful
candidate will be an M.D. or D.O. with a current, active, U.S.
state medical license and board certified in Rheumatology,
recognized by the American Board of Medical Specialties (ABMS), or
American Osteopathic Association (AOA)- Recent practice experience
in direct patient care (within the past 18 months).- Must have a
minimum of 5 years clinical experience, beyond
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
requiredThis position is not eligible to be performed in
Colorado.About CignaCigna Corporation (NYSE: CI) is a global health
service company dedicated to improving the health, well-being and
peace of mind of those we serve. We offer an integrated suite of
health services through Cigna, Express Scripts, and our affiliates
including medical, dental, behavioral health, pharmacy, vision,
supplemental benefits, and other related products. Together, with
our 74,000 employees worldwide, we aspire to transform health
services, making them more affordable and accessible to millions.
Through our unmatched expertise, bold action, fresh ideas and an
unwavering commitment to patient-centered care, we are a force of
health services innovation.When you work with Cigna, you'll enjoy
meaningful career experiences that enrich people's lives while
working together to make the world a healthier place. What
difference will you make?-- To see our culture in action, search
#TeamCigna on Instagram.Qualified applicants will be considered
without regard to race, color, age, disability, sex, childbirth
(including pregnancy) or related medical conditions including but
not limited to lactation, sexual orientation, gender identity or
expression, veteran or military status, religion, national origin,
ancestry, marital or familial status, genetic information, status
with regard to public assistance, citizenship status or any other
characteristic protected by applicable equal employment opportunity
laws.If you require reasonable accommodation in completing the
online application process, please email: for support. Do not email
for an update on your application or to provide your resume as you
will not receive a response. Keyphrases: rheumatologist jobs
Keywords: eviCore Healthcare, Melbourne , Associate Medical Director - Rheumatology - Work from home - eviCore, Executive , Melbourne, Florida
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