Field Medical Director, MSK (Spine) Surgery

Evolent Health; United States; Remote; USD 100,000 - 125,000; Full time

Job summary

Evolent Health is seeking a Field Medical Director for MSK Surgery to review Spine Surgery cases and provide clinical rationale for appeals. This non-clinical role offers a collaborative environment focused on improving healthcare outcomes, requiring an MD/DO/MBBS and strong clinical skills.

Benefits

Comprehensive health insurance

Flexible schedules

Work/life balance

Qualifications

• Minimum five years’ experience in Spine Surgery preferred.
• Current, unrestricted medical license in specialty required.
• Passion for quality and value in healthcare required.

Responsibilities

• Review Spine Surgery cases that do not meet medical necessity guidelines.
• Discuss determinations via peer-to-peer calls with physicians.
• Document all communications accurately and promptly.

Skills

Clinical skills

Management skills

Communication skills

Organizational skills

Proficiency with computers

Education

MD/DO/MBBS

Active Board Certification in Neurosurgery or Orthopedic Surgery

Job description

Your Future Evolves Here

Evolent partners with health plans and providers to achieve better outcomes for people with complex and costly health conditions. Working across specialties and primary care, we aim to connect fragmented healthcare systems and ensure patients receive the same level of care and compassion we would want for our loved ones.

Evolent employees enjoy work/life balance, flexible schedules, and autonomy to get things done. We believe people perform their best when supported to live their best lives and when they feel welcome to bring their whole selves to work. Diversity and inclusion are core to our business.

Join Evolent for the mission. Stay for the culture.

What You’ll Be Doing:

As a Field Medical Director, MSK Surgery, you will review Spine Surgery cases as a specialty match reviewer. You will be a key member of the utilization management team, providing a meaningful way to impact patients' lives in a non-clinical environment. Enjoy better work-life balance on a team that values collaboration and continuous learning while improving health outcomes.

Collaboration Opportunities:

• Interact routinely with leadership, management staff, physicians, and staff when expert input is needed.

Responsibilities:

• Review Spine Surgery cases that do not initially meet medical necessity guidelines, and other imaging requests requiring specialty review by experts.
• Discuss determinations via peer-to-peer calls with requesting physicians within regulatory timeframes.
• Provide clinical rationale for standard and expedited appeals.
• Use clinical review guidelines to ensure consistency and compliance with policies and accreditation standards.
• Support and serve as a resource to initial clinical reviewers.
• Document all communications accurately and promptly.
• Participate in ongoing training and quality assurance activities.
• Assist in research activities related to utilization management as needed.
• Potentially serve as Medical Director for select health plans or regions, overseeing utilization management activities.

Qualifications - Required and Preferred:

• MD/DO/MBBS – Required
• Minimum five years’ experience in Spine Surgery – Preferred
• Current, unrestricted medical license in your specialty – Required
• Active Board Certification in Neurosurgery or Orthopedic Surgery – Required
• Strong clinical, management, communication, and organizational skills – Required
• Passion for quality and value in healthcare – Required
• Proficiency with computers – Required

Technical Requirements:

High-speed internet (>10 Mbps) and direct connection capability to the home router are required. These requirements may change with office reopenings.

Equal Opportunity Statement:

Evolent is an equal opportunity employer. We consider all qualified applicants regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability. For accommodations, contact [e-mail].

The expected salary range is $130-$150/hr, with potential bonuses based on performance. We offer comprehensive benefits, including health insurance. Compensation varies based on skills and experience.