Medical Director, Post Acute Care

Cigna Healthcare; United States; Remote; USD 208,000 - 346,000; Full time

Benefits offered by this job

Benefits start day one

Remote work from home

8 Paid Holidays + 23 PTO Days

401(K) with company match

CME reimbursement

Career growth opportunities

Networking with peers across medical 2

Health and well-being programs

Job summary

The Cigna Group, via its EviCore division, seeks a Medical Director to perform evidence-based medical reviews and consult with referring providers. This remote role leverages your clinical expertise to guide medical necessity decisions and patient care.

You will collaborate with a large physician network, stay current on regulations, and train remotely to start. A US MD/DO with board certification is required and a strong clinical background is essential.

Qualifications

• MD/DO degree and current, active U.S. state medical license.
• Board certified in PM&R, Family Medicine, Emergency Medicine or Internal Medicine.
• 3 years of relevant clinical experience post residency/fellowship.
• Knowledge of applicable state and federal laws.
• Utilization Review Accreditation Commission and NCQA standards are a plus.
• Ability to commit to a set weekly schedule (Mon–Fri).
• Strong computer skills and ability to work autonomously with automated processes.

Responsibilities

• Complete time-sensitive, evidence-based medical case reviews for medical necessity.
• Conduct peer-to-peer physician consultations to discuss medical necessity and appropriateness.
• Recommend alternative services or treatments when appropriate.
• Collaborate with over 500 EviCore physicians to ensure proper patient care.

Skills

Clinical judgment

Communication skills

Typing / computer skills

Education

MD/DO degree

US medical license

Board certification (PM&R / Family Med / EM / Internal Med)

Job description

Job Description

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 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 PM&R, Family Medicine, Emergency Medicine and Internal Medicine, recognized by the American Board of Medical Specialties, or American Osteopathic Association
• Eligible to acquire additional state licensure as required
• 3 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 207,800 - 346,300 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.

At The Cigna Group, 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), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs.

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 need a reasonable accommodation to complete the online application process, please email [e-mail] for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

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.