Physician / Gastroenterology / Texas / Permanent / Associate Medical Director - Gastro - 100% R[...]

eviCore healthcare; San Antonio (TX); Hybrid; USD 150,000 - 220,000; Full time

Job summary

An established industry player in healthcare is seeking a dedicated medical professional to provide expert reviews and peer discussions regarding service necessity. This role offers a predictable work schedule with no nights or weekends, ensuring a work-life balance. Candidates must be board certified in Gastroenterology and possess recent clinical experience. The organization promotes a collaborative culture and offers generous benefits, including flexible scheduling, ample PTO, and educational assistance. Join a supportive team committed to making a positive impact on healthcare and employee well-being.

Benefits

Flexible Scheduling

4 Weeks PTO

Paid CME

Education Assistance

Health Benefits

Paid Volunteer Days

401k with Company Match

Qualifications

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

Responsibilities

• Provides expert medical review for service necessity evaluations.
• Conducts peer-to-peer discussions with physicians regarding review outcomes.

Skills

Gastroenterology

Clinical Experience

Knowledge of State and Federal Laws

Utilization Review Criteria

Computer Applications

Education

M.D. or D.O.

Board Certified in Gastroenterology

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

The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Gastroenterology, 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

No nights, no weekends, not call.
Predictable work schedule
Full and part time opportunities
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:
Flexible scheduling and work/life balance with remote and work from home opportunities
4 weeks of PTO(starting) per year plus paid holidays
One week of CME
Education assistance, tuition reimbursement and professional certifications
Health, dental, vision, and life benefits with employer funded HSA
Paid Volunteer Community Service Days
Ample opportunities for growth, advancement, and promotion
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