Associate Medical Director - Rheumatology - Work from home - eviCore

Company: eviCore Healthcare
Location: Melbourne
Posted on: April 6, 2021

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

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