Field Medical Director, Vascular Surgery

🔥 19 hours ago

🇺🇸 United States – Remote

⏱ Part Time

🔴 Lead

👨‍⚕️ Medical Director

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Evolent

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

⚕️ Healthcare Insurance

🏥 Healthcare

☁️ SaaS

Healthcare Insurance • Healthcare • SaaS

Evolent is a healthcare company focused on improving care outcomes through its comprehensive management solutions across multiple medical specialties. They aim to enhance the patient care journey by offering coordinated services in areas like oncology, cardiology, musculoskeletal disorders, and primary care, while ensuring high-quality treatment pathways and cost management. Evolent believes every person deserves quality care, striving to align treatment guidelines and innovative approaches to meet patient needs effectively.

📋 Description

• Serve as the specialty match reviewer in Vascular cases that do not initially meet applicable medical necessity guidelines • Review other imaging requests when providers, clients, or state laws require specialty reviews by the subject matter expert • Discuss determinations through peer-to-peer phone calls with requesting physicians or ordering providers within regulatory timeframes • Provide clinical rationale for standard and expedited appeals • Utilize medical/clinical review guidelines and parameters to ensure consistency, appropriate utilization, and compliance with SBU policies/procedures, URAC, and NCQA guidelines • Aid and act as a resource to Initial Clinical Reviewers • Ensure timely and accurate documentation of communications with medical office staff and/or physician providers • Participate in ongoing training through the inter-rater reliability process • Assist the Senior Medical Director with research related to utilization management processes, interpretation, guidelines, and/or system support • Function as Medical Director for selected health plans or regions on request, assuming accountability for utilization management with the Senior Medical Director • Routinely interact with leadership, management staff, other physicians, and staff when physician input is needed

🎯 Requirements

• MD/DO/MBBS required • Current, unrestricted clinical license in medicine or required specialty required • Obtaining and maintaining medical licenses in the state you reside required • Active Board Certification in Vascular Surgery, or Active Board Certification in General Surgery with extensive experience in Vascular Surgery, required • Strong clinical, management, communication, and organizational skills required • Energetic and curious with a passion for quality and value in health care required • Computer proficiency required • Minimum of five (5) years’ experience in the practice of Vascular Surgery preferred • High-speed internet over 10 Mbps at home • Ability for call center employees to plug directly into the home internet router • Government-issued photo ID submission and identity verification • Comprehensive background check • In-person I-9 verification • May be subject to drug screening prior to employment • AI tools prohibited during interviews • Misrepresentation results in immediate disqualification

🏖️ Benefits

• Work/life balance • Flexible work arrangements • Autonomy • Comprehensive benefits, including health insurance benefits, for qualifying employees

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