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Job ID 2109656
Job Description
Join our dynamic team where you will play a crucial role in delivering expert medical reviews to assess the medical necessity of services that do not align with our established utilization review criteria. Your insights and evaluations will significantly impact patient care while working remotely from anywhere within the United States.
As a key member of our team, you will review appeals for denied services, drawing on your current relevant medical expertise and knowledge in alignment with our appeal policies as necessary. Engaging in timely peer-to-peer discussions with referring physicians, you will clarify clinical information and articulate the rationale behind review outcome decisions.
We seek a dedicated M.D. or D.O., holding an active medical license in a U.S. state and board certified in Maternal-Fetal Medicine by the American Board of Medical Specialties (ABMS). You should have recent experience in direct patient care—ideally within the last 18 months—and a minimum of 5 years of clinical experience post-residency or fellowship. Familiarity with state and federal regulations, URAC and NCQA standards is a plus, and competency with automated processes and computer systems is essential.
Enjoy a fulfilling work-life balance with predictable hours as this role involves no nights, weekends, or on-call shifts. We offer flexible full-time and part-time opportunities, along with a competitive salary and comprehensive benefits package:
- Start with 4 weeks of paid time off annually plus paid holidays.
- Receive one week earmarked for Continuing Medical Education (CME).
- Access to educational assistance, $tuition reimbursement, and support for professional certifications.
- Comprehensive health, dental, vision, and life insurance, paired with employer-funded Health Savings Accounts (HSAs).
- Dedicated Paid Volunteer Community Service Days.
- Explore abundant prospects for growth, advancement, and promotion within our supportive and collaborative culture.
- Participate in our 401k retirement plan, featuring a generous company match of 50% on employee contributions up to 6%.
At eviCore healthcare, we’re committed to making impactful changes in healthcare while also nurturing our employees’ well-being. We pride ourselves on fostering a diverse workforce and are an Equal Opportunity Employer, making hiring decisions based on merit without any discrimination. Candidates should be prepared to pass a drug test and background investigation as part of our hiring process.
Elevate your career with us and contribute to improving healthcare outcomes!