Field Medical Director – Internal Medicine, Emergency Medicine, Cardiology
Evolent
full-time
Posted on:
Location Type: Remote
Location: United States
Visit company websiteExplore more
Salary
💰 $96 - $100 per hour
Job Level
About the role
- Serve as the specialty-match reviewer for diagnostic cardiology cases
- Review all cases in which clinical determinations cannot be made by Initial Clinical Reviewers
- Provide clear, evidence-based clinical rationale for standard and expedited appeals
- Conduct peer-to-peer discussions with requesting physicians or ordering providers
- Utilize medical and clinical review guidelines and parameters to ensure consistency in physician review processes
- Assist and act as a clinical resource to Field Medical Directors and Initial Clinical Reviewers
- Ensure all communications with medical office staff and/or physician providers are documented accurately
- Participate in ongoing training initiatives
- Assist the Senior Medical Director with research activities and questions
- Review appeal cases and/or attend hearings to support utilization management determinations
- Function as Medical Director for select health plans or regions as requested
Requirements
- DO, MD, or MBBS degree from an accredited institution
- Current Board Certification in Emergency Medicine or Internal Medicine by an American Certifying Board
- Current, unrestricted medical license in one or more U.S. states
- Current Unrestricted Medical License in Home State
- Demonstrated strong knowledge of diagnostic cardiology, including evaluation and management of cardiovascular conditions
- Five (5) years of post-residency clinical experience
- Strong verbal and written communication skills, including the ability to effectively engage in peer-to-peer discussions with treating providers
- Proficient computer skills and experience working with clinical review and documentation systems
- Active clinical practice experience within the past 18 months
- Familiarity with utilization management principles and procedures within managed care organizations
Benefits
- Health insurance benefits
- Comprehensive benefits to qualifying employees
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
diagnostic cardiologyevaluation and management of cardiovascular conditionsclinical review guidelinesutilization management principlespeer-to-peer discussionsclinical documentationevidence-based clinical rationaleresearch activitiesmedical review processesclinical resource assistance
Soft Skills
strong verbal communicationstrong written communicationinterpersonal skillsorganizational skillscollaborationtraining participationclinical resource supportengagement with providersaccuracy in documentationproblem-solving
Certifications
DOMDMBBSBoard Certification in Emergency MedicineBoard Certification in Internal Medicineunrestricted medical licenseactive clinical practice certificationclinical training certificationsmedical board certificationsspecialty certifications