Evolent
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.
Endocrinology Physician Reviewer – Radiology
🕒 June 17
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Evolent
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 • Discusses determinations (peer to peer phone calls) with requesting physicians • Utilizes medical/clinical review guidelines and parameters • Aids and acts as a resource to Initial Clinical Reviewers • Ensures documentation of all communications with medical office staff • May assist the Senior Medical Director in research activities/questions
🎯 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 • 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
• Comprehensive benefits (including health insurance benefits)
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