Associate Medical Directors (AMD) provide timely expert medical review of medical necessity requests for clinical services and render a clinical opinion about the medical service under review while located in a state or territory of the United States. AMDs also evaluate appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies. They also provide timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. AMDs document all actions related to clinical review sessions and attest to appeal review qualifications as required by law and Health Plans to retrieve reportable data. AMDs are to be stewards of eviCore healthcare’s Mission, Vision and Values by supporting and communicating eviCore policies and procedures to the provider community during medical review. AMDs also actively participate in strategic planning for and evaluation of the Care Management process/unit and assist with staff educational training and in-service programs and serves as a clinical resource for eviCore staff.
eviCore offers work/life balance with predictable work schedule, remote work opportunities - full and part time.
Minimum Experience Required:
Must have a minimum of five (5) years of clinical practice experience past fellowship training. Knowledge of applicable state and federal laws, URAC and NCQA standards, and utilization management. Familiarity with automated processes and computer applications and systems also required.
Medical Degree and current, pertinent Board Certification with an active unrestricted license to practice medicine in a state or territory the United States as a utilization review doctor of medicine or doctor of osteopathic medicine.
A SIGN ON BONUS IS AVAILALBE FOR PHYSICIANS WHO CAN BEGIN EMPLOYMENT BY THE END OF THE YEAR
eviCore healthcare offers proven, diversified medical benefit management solutions that help clients reduce costs while increasing quality of care for their members. Replying on our team of specialized medical professional resources, extensive evidence-based guidelines, and advanced technologies, we help those we serve navigate the healthcare system, find the right care path, and enable the best outcomes.