PHYSICIAN / SURGERY - ORTHOPEDICS / CALIFORNIA / PERMANENT / ASSOCIATE MEDICAL DIRECTOR - ORTHO[...]

eviCore healthcare; San Diego (CA); Remote; USD 150,000 - 200,000; Full time

Job summary

Join a supportive organization committed to providing expert medical reviews and peer discussions in a collaborative environment. This role offers a predictable work schedule with no nights or weekends, ensuring a work-life balance. Enjoy the flexibility of remote work options and generous benefits, including health, dental, and vision coverage, along with a robust retirement plan. With opportunities for professional growth and a commitment to diversity, this position is perfect for experienced medical professionals looking to make a meaningful impact in healthcare.

Benefits

Flexible Scheduling

Four Weeks of PTO

Education Assistance

Health Benefits

401k Retirement Plan

Paid Volunteer Community Service Days

Tuition Reimbursement

Professional Certifications

Collaborative Culture

Predictable Work Schedule

Qualifications

• An M.D. or D.O. with a current, active, U.S. state medical license.
• Board certified in Surgery - Orthopedics, recognized by the ABMS.
• Minimum of 5 years clinical experience beyond residency/fellowship.

Responsibilities

• Provides expert medical review for evaluating medical necessity.
• Conducts peer-to-peer discussions with referring physicians.
• Participates in strategic planning for Care Management.

Skills

Clinical Experience

Medical Review

Peer-to-Peer Discussions

Knowledge of State and Federal Laws

Familiarity with Automated Processes

Education

M.D. or D.O. with U.S. State Medical License

Board Certification in Surgery - Orthopedics

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 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

1. An M.D. or D.O. with a current, active, U.S. state medical license.
2. Board certified in Surgery - Orthopedics, recognized by the American Board of Medical Specialties (ABMS).
3. Recent practice experience in direct patient care (within the past 18 months).
4. Minimum of 5 years clinical experience beyond residency/fellowship.
5. Knowledge of applicable state and federal laws, URAC and NCQA standards is a plus.
6. 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 collaborative culture.
• Flexible scheduling and remote work options.
• Four weeks of PTO (starting) per year plus paid holidays.
• 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% 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 investigation.