Remote Field Medical Director: Orthopedic Surgery (MSK)

Evolent; Cheyenne (WY); Remote; USD 193,000 - 207,000; Full time

Benefits offered by this job

Health insurance

Job summary

Evolent is seeking a Field Medical Director, MSK Surgery, to join our utilization management team in a remote-capable role. You will review orthopedic cases, provide clinical rationale, and collaborate with physicians to ensure appropriate medical necessity determinations.

This non-clinical position offers meaningful impact, strong collaboration, ongoing learning, and the chance to help health plans and providers improve outcomes while maintaining work-life balance.

Qualifications

• MD/DO/MBBS degree required.
• Minimum of five years’ medical practice with active clinical work in the last 2 years preferred.
• Current, unrestricted medical license in the relevant specialty.
• Maintaining medical licenses in the state of residence and any business needs.
• Active Board Certification in Orthopedic Surgery.
• Strong clinical, management, communication, and organizational skills.
• Proficient computer skills.
• Not excluded from Medicare/Medicaid or other health programs.
• No major disciplinary actions by a state medical board.

Responsibilities

• Serve as the physician match reviewer in Hip/Knee/Shoulder Surgery and other imaging reviews.
• Discuss determinations with requesting physicians within regulatory timeframes, providing clinical rationale for appeals.
• Ensure consistency with URAC/NCQA guidelines and internal policies.
• Aid Initial Clinical Reviewers as needed.
• Document all communications with medical staff in a timely, accurate manner.
• Assist the Senior Medical Director with research questions related to Utilization Management.
• Participate in ongoing training per inter-rater reliability process.

Skills

Communication skills

Organization

Computer proficiency

Team collaboration

Education

MD/DO/MBBS

Medical license (unrestricted)

Board Certification in Orthopedic Surgery

Job description

Evolent is seeking a Field Medical Director, MSK Surgery, to join our utilization management team in a remote-capable role. You will review orthopedic cases, provide clinical rationale, and collaborate with physicians to ensure appropriate medical necessity determinations.

This non-clinical position offers meaningful impact, strong collaboration, ongoing learning, and the chance to help health plans and providers improve outcomes while maintaining work-life balance.