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Evolent seeks a FMD in Radiology for its utilization management team in Des Moines, Iowa. As part of a collaborative team, you will enhance patient outcomes through the review of imaging requests while enjoying a supportive work-life balance. Candidates should possess an MD or equivalent, with a strong clinical background and relevant management skills.
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 individuals receive compassionate, high-quality care.
Our employees enjoy work/life balance, flexible schedules, and autonomy, fostering an environment where they can perform their best work while living fulfilling lives. Diversity and inclusion are integral to our culture.
Join Evolent for a meaningful mission and a supportive culture.
Job Description
As a FMD, Radiology, you will be a key member of the utilization management team, contributing to improved patient outcomes in a non-clinical setting. You will work in a collaborative environment that values continuous learning and work-life balance.
Responsibilities :
- Review imaging cases that do not meet initial medical necessity guidelines and other imaging requests requiring specialty review.
- Conduct peer-to-peer discussions with requesting physicians within regulatory timeframes, providing clinical rationale for decisions and appeals.
- Use medical review guidelines to ensure consistent, compliant reviews aligned with policies and accreditation standards.
- Support initial clinical reviewers and document all communications accurately and promptly.
- Assist senior leadership with research related to utilization management and system support.
- Participate in ongoing training to maintain inter-rater reliability.
- MD, DO, or MBBS with at least five years of post-residency clinical practice, active within the last two years preferred.
- Current, unrestricted medical license in your specialty.
- Board certification by an accredited organization.
- Strong clinical, management, communication, and organizational skills.
- Passion for quality and value in healthcare.
- No current exclusions or sanctions from healthcare programs or legal actions against your medical license.
High-speed internet (>10 Mbps) at home, with the ability to connect directly to the router for call center roles. These requirements may change with office reopenings.
Evolent is an equal opportunity employer. If accommodations are needed to access our website or apply, please contact [emailprotected].
The salary range for this role is $95-110/hr, plus potential performance bonuses. We offer comprehensive benefits, including health insurance, with compensation based on experience and skills.
If this role isn't a perfect fit, submit your contact info and resume for future opportunities.
Medical Director Neurology • Des Moines, IA, United States