Physician / Surgery - Orthopedics / Texas / Permanent / Associate Medical Director - Orthopedic[...]

eviCore healthcare; Houston (TX); Remote; USD 200,000 - 300,000; Full time

Job summary

Join a forward-thinking healthcare organization dedicated to providing expert medical reviews and ensuring quality patient care. This role offers the opportunity to engage in peer discussions, maintain necessary credentials, and participate in strategic planning within a supportive and collaborative environment. Enjoy a predictable work schedule with no nights or weekends, along with generous benefits including flexible scheduling, PTO, and a robust retirement plan. If you are a passionate medical professional looking for a fulfilling career path with opportunities for growth, this position is perfect for you.

Benefits

Flexible scheduling

4 weeks of PTO

CME and education assistance

Health, dental, vision benefits

Paid volunteer community service days

401(k) retirement plan with company match

Qualifications

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

Responsibilities

• Conduct timely expert medical reviews for service evaluations.
• Engage in peer-to-peer discussions with referring physicians.

Skills

Medical Review

Clinical Experience

Knowledge of URAC and NCQA Standards

Computer Applications

Education

M.D. or D.O.

Board Certification in Surgery - Orthopedics

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 and evaluation of the Care Management team.

Qualifications

• The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license.
• Board certified in Surgery - Orthopedics, 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 Environment and Benefits

• No nights, no weekends, no call.
• Predictable work schedule with 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.
• 401(k) retirement plan with a company match of 50% on employee contributions up to 6%.

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.