Radiation Oncology Field Medical Director

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🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $130 - $145 / hour

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

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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 Physician match reviewer in Radiation Oncology and imaging cases that do not initially meet applicable medical necessity guidelines • Complete specialty reviews for imaging requests when providers, clients, or state laws require subject matter expert review • Discuss determinations 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 policies and URAC/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 MD providers • Assist the Senior Medical Director with research related to utilization management processes, interpretation, guidelines, and system support • Participate in ongoing training under the inter-rater reliability process • Interact routinely with leadership, management staff, other physicians, and staff when physician input is needed

🎯 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 medicine or required specialty • Obtain and maintain medical licenses in the state of residence and any licenses required by business needs • Active Board Certification in Radiation Oncology • Strong clinical, management, communication, and organizational skills • Computer proficiency • Energetic and curious with a passion for quality and value in health care • Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid • Not identified as an excluded person by the Office of Inspector General of HHS or GSA • No history of a major disciplinary or legal action by a state medical board • Comprehensive background check, in-person I-9 verification, and possible drug screening prior to employment • Government-issued photo ID submission and identity verification during interviews • High-speed internet over 10 Mbps at home • Ability to plug directly into the home internet router for applicable call-center work • Artificial intelligence tools prohibited during interviews

🏖️ Benefits

• Work/life balance • Flexibility to suit work to employees’ lives • Autonomy to get things done • Health insurance benefits for qualifying employees • Comprehensive benefits for qualifying employees