Medical Director – Pediatric Nephrology

The Cigna Group

Medical Director at EviCore applying Pediatric Nephrology expertise to conduct medical necessity reviews. Collaborating with healthcare providers for high-quality patient care in a remote capacity.

Posted 6/3/2026full-timeRemote • 🇺🇸 United StatesLead💰 $207,800 - $346,300 per yearWebsite

About the role

Key responsibilities & impact

As a Medical Director at EviCore, you’ll leverage your background in Pediatric Nephrology to deliver evidence-based medical reviews that support high-quality patient care.
Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases.
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

What you’ll need

M.D. or D.O. with a current, active U.S. medical license and board certification (ABMS or AOA) in Pediatric Nephrology.
Eligible to acquire additional state licensure as required
3 or more 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. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Benefits

Comp & perks

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

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

Pediatric Nephrologyevidence-based medical reviewsmedical necessityclinical expertisepeer-to-peer consultationUtilization Review Accreditation Commission standardsNational Committee for Quality Assurance standardsclinical experienceautomated processescomputer applications

Soft Skills

collaborationcommunicationautonomytime managementleadership

Certifications

M.D.D.O.board certification in Pediatric Nephrology