Physician / Cardiology / California / Permanent / Associate Medical Director - Cardiology - 100[...]

eviCore healthcare; Riverside (CA); Remote; USD 90,000 - 150,000; Full time

Job summary

An established industry player in healthcare is seeking a qualified medical professional to provide expert reviews and engage in peer discussions regarding medical necessity. This role emphasizes collaboration and strategic planning within care management, and requires a candidate with a strong clinical background and recent patient care experience. The organization values a supportive culture and offers flexible scheduling, generous PTO, and opportunities for professional growth. If you are passionate about making a positive impact in healthcare and thrive in a collaborative environment, this is the perfect opportunity for you.

Benefits

Flexible Scheduling

4 Weeks of PTO

One Week of CME

Education Assistance

Health, Dental, Vision Benefits

Paid Volunteer Community Service Days

401k Retirement Plan with Company Match

Qualifications

• Must have a current, active U.S. state medical license and board certified in Cardiology.
• Minimum of 5 years clinical experience, beyond residency/fellowship.

Responsibilities

• Provides expert medical review for services not meeting utilization review criteria.
• Conducts peer-to-peer discussions with referring physicians regarding clinical information.

Skills

Medical Review

Clinical Experience

Knowledge of State and Federal Laws

Familiarity with Automated Processes

Education

M.D. or D.O. Degree

Board Certification in Cardiology

Tools

Computer Applications and Systems

Job description

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.

Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.

Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.

Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications.

Participates in strategic planning for and evaluation of the Care Management.

Qualifications

The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Cardiology, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the past 18 months).

Must have a minimum of 5 years clinical experience, beyond residency/fellowship.

Knowledge of applicable state and federal laws, URAC and NCQA standards a plus, and familiarity with automated processes and computer applications and systems is required.

Opportunities

Full and part-time opportunities available.

Salaried position with benefits.

Supportive organization with collaborative culture.

eviCore healthcare is committed to making a positive impact on healthcare, and also making a positive impact on our employees. eviCore offers a variety of perks and benefits including, but not limited to:

1. Flexible scheduling and work/life balance with remote and work from home opportunities.
2. 4 weeks of PTO (starting) per year plus paid holidays.
3. One week of CME.
4. Education assistance, tuition reimbursement, and professional certifications.
5. Health, dental, vision, and life benefits with employer funded HSA.
6. Paid Volunteer Community Service Days.
7. Ample opportunities for growth, advancement, and promotion.
8. 401k retirement plan with company match of 50% employee contributions up to 6%.

eviCore is committed to hiring and retaining a diverse workforce. We are an Equal Opportunity Employer, making decisions without regard to race, color, religion, sex, national origin, age, veteran status, disability, or any other protected class. Applicants must be able to pass a drug test and background investigation.