Field Medical Director, Physical Medicine
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Job Description
Field Medical Director for utilization management in physical medicine and rehabilitation within Evolent. Collaborating with providers and ensuring adherence to medical necessity guidelines for patient care.
Responsibilities:
- Serve as the Physician match reviewer in PM&R cases
- Discusses determinations (peer to peer phone calls) with requesting physicians or ordering providers
- 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
- May assist the Senior Medical Director in research activities/questions related to the Utilization Management process
- Participates in on-going training per inter-rater reliability process
Requirements:
- MD/DO/MBBS- Required
- Minimum of five (5) years’ experience in the practice of Medicine, post residency and Active Clinical practice within the last 2 years- Preferred
- Current, unrestricted clinical license in medicine or required specialty- Required
- Obtaining and maintaining medical licenses in the state you reside, as well as, any license required per business needs- Required
- Active Board Certification in Physical Medicine and Rehabilitation- 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:
- Comprehensive benefits (including health insurance benefits)
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