Physician / Oncology - Radiation / Illinois / Permanent / Associate Medical Director - Radiatio[...]

eviCore healthcare; Illinois; Remote; USD 150,000 - 200,000; Full time

Job summary

An established industry player is seeking a dedicated Medical Reviewer to evaluate medical necessity requests. This role involves conducting peer discussions with referring physicians, ensuring compliance with utilization review criteria, and maintaining necessary medical credentials. The ideal candidate will hold an M.D. or D.O. with board certification in Oncology Radiation and possess recent clinical experience. Enjoy a predictable work schedule with no nights or weekends, and benefit from a supportive culture that values work-life balance and professional growth opportunities.

Benefits

Flexible Scheduling

4 Weeks PTO

CME Opportunities

Education Assistance

Health Benefits

Paid Volunteer Days

401k Plan with Company Match

Qualifications

• Must have a current, active U.S. state medical license.
• Recent practice experience in direct patient care required.

Responsibilities

• Provides expert medical review for service requests.
• Conducts peer-to-peer discussions with physicians.

Skills

Medical Review

Peer-to-Peer Discussions

Clinical Knowledge

Knowledge of State and Federal Laws

Computer Applications

Education

M.D. or D.O.

Board Certification in Oncology Radiation

5+ Years Clinical Experience

Tools

Automated Processes

Job description

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 delegated.

Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and 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 process.

Qualifications

• The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license.
• Board certified in Oncology Radiation, recognized by the American Board of Medical Specialties (ABMS).
• Recent practice experience in direct patient care (within the past 18 months).
• Minimum of 5 years clinical experience beyond residency/fellowship.
• 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.

Work Schedule and Benefits

No nights, no weekends, no call. Predictable work schedule. Full and part-time opportunities. Salaried position with benefits. Supportive organization with a collaborative culture.

Perks and Benefits

• 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.
• Opportunities for growth, advancement, and promotion.
• 401k retirement plan with company match of 50% up to 6% of employee contributions.

Equal Opportunity Employment

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 pass a drug test and background check.