Medical Director -Pediatric Surgery

Cigna in; Bloomfield (CT); Remote; USD 203,000 - 339,000; Full time

Job summary

A leading healthcare organization is seeking a Medical Director of Pediatric Surgery to provide evidence-based medical reviews and collaborate with healthcare providers. This remote role offers full-time and part-time opportunities, competitive salary, and comprehensive benefits starting on day one, including medical, dental, and 401(k) matching.

Benefits

Benefits start on day one

100% work from home

401(K) with company match

Reimbursement for continuing medical education

23 PTO Days

8 Paid Holidays

Qualifications

• Must have a current, active U.S. state medical license.
• At least 5 years of relevant clinical experience post-residency/fellowship.
• Strong computer skills and ability to work autonomously.

Responsibilities

• Conduct evidence-based medical case reviews for medical necessity.
• Collaborate with healthcare providers for peer-to-peer consultations.
• Recommend alternative services or treatments as necessary.

Skills

Clinical judgment

Communication

Technology skills

Typing skills

Education

M.D. or D.O. with board certification in Pediatric Surgery

Job description

Medical Director - Pediatric Surgery (Finance)

Medical Director - Pediatric Surgery - Evicore - Remote

We have both full-time and part-time opportunities available.

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 Surgery Medical Director at Evicore, part of Evernorth Health Services, a division of The Cigna Group, you'll use your clinical knowledge 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 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:

1. Start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success.
2. Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on eviCore's case management software.
3. Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence-based medical necessity and appropriateness of the requested service or treatment.
4. Leverage your clinical expertise to recommend alternative services or treatments as necessary.
5. 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 certification in Pediatric Surgery recognized by the American Board of Medical Specialties or the American Osteopathic Association
• Eligible to acquire additional state licensure as required
• At least 5 years of relevant clinical experience post-residency/fellowship
• Knowledge of applicable state and federal laws
• Utilization Review Accreditation Commission and National Committee for Quality Assurance standards are 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 typing, speaking, and listening 100% of the time
• Company-provided encrypted workstation is required to be hard-wired connected to a modem or router; wireless connection is not permitted.

If working from home occasionally or permanently, your internet connection must be through a cable broadband or fiber optic provider with speeds of at least 10 Mbps download / 5 Mbps upload.

For this position, the anticipated annual salary ranges from $203,200 to $338,600, depending on experience and location. The role is also expected to be eligible for an annual bonus plan.

We support your whole health with comprehensive benefits starting on day one, including medical, vision, dental, well-being and behavioral health programs. Additional benefits include 401(k) with company match, company-paid life insurance, tuition reimbursement, at least 18 days of paid time off per year, and paid holidays. For more information, visit Life at Cigna Group.

About Evernorth Health Services

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

Qualified applicants will be considered regardless of race, color, age, disability, sex, pregnancy, sexual orientation, gender identity, veteran or military status, religion, national origin, marital or familial status, genetic information, public assistance status, citizenship, or other protected characteristics.

If you need reasonable accommodation to complete the online application, please email: [e-mail]. Do not email this address for updates on your application or to submit resumes, as responses will not be provided.

The Cigna Group maintains a tobacco-free policy and may not hire tobacco/nicotine users in states where permitted. Candidates in such states who use tobacco/nicotine will need to enter a qualifying smoking cessation program prior to employment. States include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington.

Qualified applicants with criminal histories will be considered consistent with applicable laws.