Job Description: Join us as an Associate Medical Director at eviCore, where you’ll be empowered to make a difference in the lives of patients by improving the quality of healthcare nationwide. Job Responsibilities: 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. 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. 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. Job Requirements: 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) M.D. or D.O. with a current, active, U.S. state medical license and board certified in Cardiology, recognized by the American Board of Medical Specialties (ABMS), or American Osteopathic Association (AOA) Strong computer skills; ability to work autonomously with automated processes and computer applications and systems is required Qualification & Experience: Must have a minimum of 5 years clinical experience, beyond residency/fellowship Recent practice experience in direct patient care (within the past 18 months) Job Details: Company: Express Scripts Vacancy Type: Full Time Job Location: Melbourne, FL, US Application Deadline: N/A Apply Here vacanciesforyou.net
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