Field Medical Director, Vascular Surgery
Evolent
part-time
Posted on:
Location Type: Remote
Location: United States
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Job Level
About the role
- Serve as the specialty match reviewer in Vascular cases, that do not initially meet the applicable medical necessity guidelines
- Discusses determinations (peer to peer phone calls) with requesting physicians or ordering providers, when available
- Provides clinical rationale for standard and expedited appeals
- Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process
- Aids and acts as a resource to Initial Clinical Reviewers
- Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner
- Participates in on-going training per inter-rater reliability process
- May assist the Senior Medical Director in research activities/questions related to the Utilization Management process
Requirements
- MD/DO/MBBS- Required
- Minimum of five (5) years’ experience in the practice of Vascular Surgeon- Preferred
- Current, unrestricted clinical license in medicine or required specialty- Required
- Obtaining and maintaining medical licenses in the state you reside and licensure per business need- 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
Benefits
- Health insurance benefits
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
Vascular SurgeryClinical ReviewMedical Necessity GuidelinesUtilization ManagementPeer to Peer CommunicationClinical RationaleDocumentationInter-Rater ReliabilityResearch Activities
Soft Skills
CommunicationOrganizational SkillsManagement SkillsEnergeticCuriosityPassion for QualityValue in Health Care
Certifications
MDDOMBBSBoard Certification in Vascular SurgeryBoard Certification in General Surgery