Medical Director- Radiation Oncology - EviCore

* Job Description Summary

Guides the company on strategic Utilization Review decisions and provides medical advice that has a significant impact on strategic planning and patient treatment.

Widely recognized Medical Direction expert and thought leader by both internal and external community.

Provides professional guidance and assistance in the evaluation of medical factors of proposed risks.

Establishes research parameters and maintains a system/process that evaluates the quality and medical utilization of members.

May prescribe procedures and provide interpretations of laboratory, EKG, and X-ray results involved in risk appraisal.

Establishes and implements policies and standards, evaluate new treatments, and conduct medical research to ensure the quality of the medical care provided to patients.

Implements utilization and financial initiatives.

Responsible for program execution and drives utilization review medical program management for specific clinical programs.

Develops and manages efforts to improve and maintain cost and utilization trends.

Requires an MD, DO or DC.

Hiring Requirements

Job Details



* Do you crave an intellectually stimulating job that allows you to leverage your clinical expertise while developing new skills and improving the lives of others? Then look no further! As a Radiation Oncology Medical Director at eviCore, part of Evernorth Health Services, a division of The Cigna Group, you'll use your clinical know-how to provide evidence-based medical reviews for patient care.

Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases.

This role offers you the opportunity to build new skills while enhancing the health and vitality of others.

We're seeking a detail-oriented individual with good communication, technology, and typing skills, as well as strong clinical judgment.

Drive growth in your career with our innovative team.



* How you'll make a difference:
+ 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.

What you'll enjoy about working here:
+ Benefits start on day one
+ Predictable work schedules
+ 100% work from home
+ 8 Paid Holidays + 23 PTO Days
+ 401(K) with company ...