Physician / Surgery - Orthopedics / New York / Permanent / Associate Medical Director - Orthope[...]

eviCore healthcare; New York (NY); Remote; USD 200,000 - 250,000; Full time

Job summary

A healthcare organization is seeking an Associate Medical Director in Orthopedic Surgery. This 100% remote role requires an M.D. or D.O. with board certification and 5+ years of clinical experience. Benefits include flexible scheduling, generous PTO, and health plans. Ideal candidates will have expertise in medical necessity evaluations and familiarity with laws related to utilization review.

Benefits

Flexible scheduling

4 weeks of PTO per year

Education assistance

Health, dental, vision benefits

401k retirement plan with company match

Qualifications

• M.D. or D.O. with a current, active U.S. state medical license.
• Minimum of 5 years clinical experience.
• Recent practice experience in direct patient care.

Responsibilities

• Provide expert medical review for service necessity.
• Review appeals for denied services.
• Conduct peer-to-peer discussions to clarify clinical information.

Skills

Medical necessity evaluation

Peer-to-peer discussions

Knowledge of state and federal laws

Familiarity with automated processes

Education

M.D. or D.O.

Board certification in Surgery - Orthopedics

Job description

Overview

Physician / Surgery - Orthopedics / New York / Permanent / Associate Medical Director - Orthopedic Surgery - 100% Remote Job

Responsibilities

• 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.
• Makes sure credentials are current; 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 Surgery - Orthopedics, 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 is a plus, and familiarity with automated processes and computer applications and systems is required.

Schedule and Compensations

• No nights, no weekends, not call.
• Predictable work schedule.
• Full and part time opportunities.
• Salaried position with benefits.
• Supportive organization with collaborative culture.

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

Equal Opportunity

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.

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:

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