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Job ID 2111658
Job Description
Join our dynamic team, where your expert medical insight will shape the evaluation of medical necessity in healthcare services. In this role, you will conduct timely reviews for requests that do not align with utilization review criteria throughout various states and territories in the U.S. You’ll have the opportunity to engage in appeal reviews for denied services, leveraging your recent medical experience to adhere to established appeal policies, as directed.
You will participate in crucial peer-to-peer discussions with referring physicians to gather essential clinical information and elucidate the outcomes of reviews, fostering a collaborative approach to patient care. It’s important to maintain your credentials and promptly inform eviCore of any changes related to your medical licenses or board certifications. Moreover, you’ll take part in strategic planning and evaluation that enhances our Care Management initiatives.
Ideal candidates will hold an M.D. or D.O. degree, possess a valid U.S. state medical license, and be board certified in Neurology through the American Board of Medical Specialties (ABMS). Recent hands-on clinical experience (within the last 18 months) is essential, alongside a minimum of five years of clinical experience beyond residency or fellowship. Familiarity with applicable state and federal laws, as well as URAC and NCQA standards, is advantageous. Proficiency in automated processes and computer applications is also required.
Enjoy a work-life balance with no night shifts, weekends, or on-call duties, complemented by a predictable work schedule. We offer both full-time and part-time positions within a salaried framework that includes a comprehensive benefits package.
At eviCore healthcare, we value collaboration and support, ensuring our employees also feel fulfilled. Our benefits encompass:
- Flexible scheduling and remote work options, promoting work-life harmony
- An initial offering of 4 weeks PTO per year, plus paid holidays
- One week dedicated to Continuing Medical Education (CME)
- Education assistance, including tuition reimbursement and support for professional certifications
- Comprehensive health, dental, vision, and life insurance, with employer-funded Health Savings Accounts (HSA)
- Paid Volunteer Community Service Days to engage with your community
- Significant opportunities for career growth and progression
- A 401k retirement plan with a 50% match on employee contributions up to 6%
eviCore is dedicated to cultivating a diverse workforce and is proud to be an Equal Opportunity Employer, evaluating applicants solely on merit without regard to race, color, religion, sex, national origin, age, veteran status, disability, or any other protected characteristic. All applicants are required to pass a drug test and background check. Embrace the chance to make a meaningful impact on healthcare while furthering your career!