Medical Director - Pediatric Surgery

September 26

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The Cigna Group

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10,000+ employees

Founded 1982

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Description

• As a Pediatric Surgery Medical Director at Evicore, you'll provide evidence-based medical reviews for patient care. • Collaborate with healthcare providers and stay current on healthcare regulations and industry developments. • 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 ensure patients receive proper care via evidence-based decision making.

Requirements

• M.D. or D.O. with a current, active, U.S. state medical license and board certified in Pediatric Surgery recognized by the American Board of Medical Specialties, or American Osteopathic Association • Eligible to acquire additional state licensure as 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) • 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. • 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