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

eviCore healthcare; Texas; Remote; USD 150,000 - 250,000; Full time

Job summary

Join a supportive organization that values collaboration and work-life balance. This role involves providing expert medical reviews and engaging with physicians to clarify clinical decisions. The ideal candidate is an experienced medical professional with a strong background in gastroenterology and a commitment to patient care. Enjoy flexible scheduling, generous PTO, and opportunities for professional growth. Be part of a diverse workforce dedicated to making a difference in healthcare.

Benefits

Flexible Scheduling

4 Weeks PTO

CME Support

Tuition Reimbursement

Health Benefits

401k with Company Match

Paid Volunteer Days

Professional Certifications

Qualifications

• Active U.S. state medical license and board certification required.
• Minimum of 5 years clinical experience beyond residency/fellowship.

Responsibilities

• Reviews appeals for denied services based on medical expertise.
• Engages in peer-to-peer discussions with physicians regarding clinical information.

Skills

Clinical Experience

Medical Review Expertise

Knowledge of URAC and NCQA Standards

Familiarity with Automated Processes

Education

M.D. or D.O.

Board Certification in Gastroenterology

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.

1. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if delegated.
2. Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and explain review outcome decisions.
3. Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications.
4. Participates in strategic planning and evaluation of the Care Management team.

Qualifications:

1. The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certification in Gastroenterology, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the past 18 months).
2. Must have a minimum of 5 years of clinical experience beyond residency/fellowship.
3. Knowledge of applicable state and federal laws, URAC and NCQA standards is a plus. Familiarity with automated processes and computer applications and systems is required.

Opportunities and Benefits:

• Full and part-time opportunities
• Salaried position with benefits
• Supportive organization with a collaborative culture
• Flexible scheduling and work/life balance with remote and work-from-home options
• 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
• Opportunities for growth, advancement, and promotion
• 401k retirement plan with company match of 50% of employee contributions up to 6%

Equal Opportunity Employer:

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.