Medical Director – Pediatric Nephrology
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Job Description
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.
Responsibilities:
- 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:
- 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:
- 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
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