Remote Medical Director: Evidence-Based Care Leader

The Cigna Group; Bloomfield (CT); Remote; USD 208,000 - 346,000; Full time

Benefits offered by this job

Benefits start on day one

100% work from home

401(k) with company match

Paid holidays and PTO

Job summary

The Cigna Group's EviCore division seeks a Medical Director to provide evidence-based medical reviews for patient care. You will collaborate with providers, stay current on healthcare regulations, and leverage clinical judgment to guide treatment decisions from home.

Training starts remotely with mentors and leadership. You will lead physician consultations and contribute to care pathways while working with a large team of EviCore physicians to ensure appropriate care and outcomes.

Qualifications

• MD or DO with a current, active U.S. state medical license and board certification in PM&R, Family Medicine, Emergency Medicine or Internal Medicine.
• Eligible to acquire additional state licensure as required.
• 3 years of relevant clinical experience post residency/fellowship.
• Knowledge of applicable state/federal laws.
• Utilization Review Accreditation Commission and NCQA standards are a plus.

Responsibilities

• Perform time-sensitive, specialized evidence-based medical case reviews for medical necessity.
• Conduct physician consultations (peer-to-peer) discussing evidence-based medical necessity and appropriateness of services.
• Recommend alternative services or treatments as necessary based on clinical expertise.
• Collaborate with over 500 EviCore physician colleagues to ensure patients receive proper care via evidence-based decision making.

Skills

Communication skills

Technology proficiency

Typing skills

Clinical judgment

Education

Medical degree (MD/DO)

Board certification in PM&R / Family Medicine / Emergency Medicine / Internal Medicine

Job description

The Cigna Group's EviCore division seeks a Medical Director to provide evidence-based medical reviews for patient care. You will collaborate with providers, stay current on healthcare regulations, and leverage clinical judgment to guide treatment decisions from home.

Training starts remotely with mentors and leadership. You will lead physician consultations and contribute to care pathways while working with a large team of EviCore physicians to ensure appropriate care and outcomes.