Medical Director - Physical Medicine and Rehabilitation - EviCore - Remote

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 Durable Medical Equipment (DME) 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.


* Serve as a subject matter expert for medical necessity requests for durable medical equipment (DME), Home Health (HH) and other specialty-matched cases as indicated.


* Testify at ALJ Hearings when your cases are being appealed


* Document all actions related to clinical review sessions and attest to review qualifications as required.

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 match


* Reimbursement for continuing medical education


* Career growth opportunities across the enterprise


* Networking with peers across multiple medical specialties

Requirements:


* M.D.

or D.O.

with a current, active, U.S.

state medical license and board certified in Physical Medicine & Rehabilitation recognized by the American Board of Medical Specialties, or American Osteopathic Association


* Eligible to acquire additional state licensureas required


* 5 years of relevant clinical experience post residency/fellowship


* Knowledge of applicable state 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)


* Provide intermittent weekend ...