Express Scripts Job Openings – Associate Medical Director

Job Description:

Job Responsibilities:

• Create new knowledge with our guidelines and systems, and new relationships with your peers. You’ll start with remote training, but you’re not doing it alone. You’ll enjoy a supportive environment with your peers, mentors, and leadership who want you to succeed in your new career.
• Use your analytical mindset. Provide timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria. Review appeals for denied services related to relevant medical experience and our evidence based guidelines, in accordance with appeal policies, if so delegated.
• Be a team player. Work collaboratively with over 400 eviCore Physician Peers to help ensure patients receive proper care via evidence based decision making. Provide timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.

Job Requirements:

• Strong computer skills; ability to work autonomously with automated processes and computer applications and systems is required
• M.D. or D.O. with a current, active, U.S. state medical license and board certified in Radiation Oncology, recognized by the American Board of Medical Specialties (ABMS), or American Osteopathic Association (AOA)
• Knowledge of applicable state and federal laws. Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA)standards a plus
• The ability to commit to a set, weekly work schedule (Monday through Friday)

Qualification & Experience:

• Recent practice experience in direct patient care (within the past 18 months)
• Must have a minimum of 5 years clinical experience, beyond residency/fellowship

Job Details:

Company: Express Scripts

Vacancy Type: Full Time

Job Location: Melbourne, FL, US

Application Deadline: N/A

Apply Here

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