Rheumatologist – Physician Reviewer – Radiology

🕒 June 17

🇺🇸 United States – Remote

💵 $95 - $109 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 2%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Evolent

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Healthcare • Healthcare Insurance • Pharmaceuticals

Evolent is a health care company that partners with health plans and providers to improve outcomes for individuals with complex health conditions. The company employs a value-based care approach and works across various medical specialties, providing integrated care management solutions to ensure alignment with clinical evidence and patient preferences. Evolent aims to enhance affordability and quality in health care through its comprehensive resources, which include clinical pathways and value-based payment models. Founded in 2011, Evolent has established itself as a leader in value-based care, now serving a national network of health payers and providers, including managed Medicaid and Medicare Advantage programs.

📋 Description

• Serve as the Physician match reviewer in Imaging cases that do not initially meet the applicable medical necessity guidelines • Discusses determinations (peer to peer phone calls) with requesting physicians or ordering providers • Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process • Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner • Participates in on-going training per inter-rater reliability process.

🎯 Requirements

• MD/DO/MBBS • Minimum of five (5) years’ experience in the practice of Medicine, post residency • Active Clinical practice within the last 2 years is preferred • Current, unrestricted clinical license in home state medicine or required specialty • Active Board Certification by an accredited organization • Strong clinical, management, communication, and organizational skills • Energetic and curious with a passion for quality and value in health care • Computer Proficiency • Not under current exclusion or sanction by any state or federal health care program • No history of a major disciplinary or legal action by a state medical board.

🏖️ Benefits

• health insurance benefits