Medical Director – Pediatric Pulmonology

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The Cigna Group

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛡️ Insurance

Healthcare • Insurance

The Cigna Group is a global health services company that provides medical, dental, pharmacy, behavioral and supplemental insurance products and benefits to individuals, families, employers, brokers, providers and Medicare beneficiaries. It offers employer-sponsored group plans, individual and family plans (including Open Enrollment offerings), Medicare, international health insurance covering more than 200 countries, and digital member services through the myCigna platform (including telehealth and claims management). Its products are delivered through operating subsidiaries such as Cigna Health and Life Insurance Company and other regional affiliates.

📋 Description

• You’ll start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success. • Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on EviCore’s case management software. • Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence–based medical necessity and appropriateness of the requested service or treatment. • Leverage your clinical expertise to recommend alternative services or treatments as necessary. • Work collaboratively with over 500 EviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making.

🎯 Requirements

• M.D. or D.O. with a current, active U.S. medical license and board certification (ABMS or AOA) in Pediatric Pulmonology • Eligible to acquire additional state licensure as required • 3 years of relevant clinical experience post residency/fellowship • Knowledge of applicable state and federal laws, Utilization Review Accreditation Commission and National Committee for Quality Assurance standards is a plus • Ability to commit to a set, weekly work schedule (Monday through Friday) • Strong computer skills: ability to work autonomously with automated processes, computer applications, and systems • Meet physical demands of the role including, but not limited to, typing, speaking, and listening 100% of time • In accordance with our HITECH Security Accreditation, company provided encrypted-workstation is required to be hard-wire connected to a modem or router. Wireless connection is not permitted.

🏖️ Benefits

• Benefits start on day one • Predictable work schedules • 100% work from home • 8 Paid Holidays + 23 PTO Days • 401(K) with company match • Reimbursement for continuing medical education • Career growth opportunities across the enterprise • Networking with peers across multiple medical specialties