[Hiring] Radiation Oncology Field Medical Director @Evolent

Role Description

As a Field Medical Director in Radiation Oncology, you will be a key member of the utilization management team, making a meaningful difference in patients’ lives in a non-clinical environment. Enjoy better work-life balance on a team that values collaboration and continuous learning while providing better health outcomes.

• Serve as the Physician match reviewer in Radiation Oncology and imaging cases that do not initially meet the applicable medical necessity guidelines.
• Discuss determinations (peer to peer phone calls) with requesting physicians or ordering providers, providing clinical rationale for standard and expedited appeals.
• Utilize medical/clinical review guidelines to assure consistency in the MD review process, reflecting appropriate utilization and compliance with SBU's policies/procedures, URAC, and NCQA guidelines.
• Aid and act as a resource to Initial Clinical Reviewers.
• Ensure documentation of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner.
• Assist the Senior Medical Director in research activities/questions related to the Utilization Management process.
• Participate in ongoing training per inter-rater reliability process.

Qualifications

• MD/DO/MBBS
• Minimum of five (5) years’ experience in the practice of Medicine, post-residency.
• Active Clinical practice within the last 2 years is preferred.
• Current, unrestricted clinical license in medicine or required specialty.
• Active Board Certification in Radiation Oncology.
• Strong clinical, management, communication, and organizational skills.
• Energetic and curious with a passion for quality and value in health care.
• Computer Proficiency.
• No history of major disciplinary or legal action by a state medical board.

Requirements

• Obtaining and maintaining medical licenses in the state you reside, as well as any license required per business needs.
• Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid.
• To ensure a secure hiring process, identity verification steps are implemented, including submission of a government-issued photo ID.
• All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment.
• The use of artificial intelligence tools during interviews is prohibited and monitored.

Benefits

• Expected base salary/wage range for this position is $130-$145/hr.
• Comprehensive benefits (including health insurance benefits) to qualifying employees.