Medical Director - Pediatric Pulmonology - EviCore - Remote

Cigna Health and Life Insurance Company; United States; Remote; USD 203,000 - 339,000; Full time

Job summary

An innovative healthcare provider is seeking a Pediatric Pulmonology Medical Director to join their remote team. This role allows you to leverage your clinical expertise while conducting evidence-based medical reviews and collaborating with healthcare professionals. You'll enjoy a structured training environment and predictable work schedules, all while working from the comfort of your home. With a focus on career growth and a comprehensive benefits package starting on day one, this position offers a unique opportunity to enhance patient care and improve lives. If you're ready to make a difference in the healthcare industry, this role is perfect for you.

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

Networking with peers across specialties

Comprehensive health benefits

Qualifications

• M.D. or D.O. with active U.S. medical license and board certified in Pediatric Pulmonology.
• 5 years of relevant clinical experience post residency/fellowship.

Responsibilities

• Conduct evidence-based medical case reviews for medical necessity.
• Collaborate with healthcare providers for peer-to-peer consultations.

Skills

Clinical Judgment

Communication Skills

Technology Skills

Typing Skills

Education

M.D. or D.O.

Board Certification in Pediatric Pulmonology

Tools

eviCore’s case management software

Job description

Medical Director - Pediatric Pulmonology - EviCore - Remote

Medical Director - Pediatric Pulmonology - EviCore - Remote

Do you crave an intellectually stimulating job that allows you to leverage your clinical expertise while developing new skills and improving the lives of others? Then look no further! As a Pediatric Pulmonology Medical Director at eviCore, part of Evernorth Health Services, a division of The Cigna Group, you’ll use your clinical know-how to provide evidence-based medical reviews for patient care. Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases. This role offers you the opportunity to build new skills while enhancing the health and vitality of others. We're seeking a detail-oriented individual with good communication, technology, and typing skills, as well as strong clinical judgment. Drive growth in your career with our innovative team.

How you’ll make a difference:

• You’ll start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success.
• 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 help ensure patients receive proper care via evidence-based decision making.

What you’ll enjoy about working here:

• 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

Requirements:

• M.D. or D.O. with a current, active, U.S. state medical license and board certified in Pediatric Pulmonology, recognized by the American Board of Medical Specialties, or American Osteopathic Association
• Eligible to acquire additional state licensure as required
• Prefer one of the following state medical licenses but is not required: DC, MD or VA
• 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.

If you will be working at home occasionally or permanently, 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. For this position, we anticipate offering an annual salary of 203,200 - 338,600 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: [e-mail] for support. Do not email [e-mail] for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.