Urology- Physician Clinical Reviewer
2 months ago
Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You’ll Be Doing: As a Physician Clinical Reviewer you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical environment. You can enjoy better work- life balance on a team that values collaboration and continuous learning while providing better health outcomes. Collaboration Opportunities: Routinely interacts with leadership and management staff, other Physicians, and staff whenever a physician`s input is needed or required. What You Will Be Doing: Serve as the Physician match reviewer in Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter expert. Discusses determinations (peer to peer phone calls) with requesting physicians or ordering providers, when available, within the regulatory timeframe of the request and provides clinical rationale for standard and expedited appeals. Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. Aids and acts as a resource to Initial Clinical Reviewers. Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner. May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. Participates in on-going training per inter-rater reliability process. Qualifications - Required and Preferred: MD/DO/MBBS- Required Minimum of five (5) years’ experience in the practice of Medicine, post residency and Active Clinical practice within the last 2 years- Preferred Current, unrestricted clinical license in medicine or required specialty- Required Obtaining and maintaining medical licenses in the state you reside, as well as, any license required per business needs- Required Active Board Certification Urology (If a specialty or subspecialty, must also have that BC)- Required Strong clinical, management, communication, and organizational skills- Required Energetic and curious with a passion for quality and value in health care- Required Computer Proficiency- Required Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an “excluded person” by the Office of Inspector General of the Department of Health and Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare. No history of a major disciplinary or legal action by a state medical board Technical Requirements: We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations. Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status. If you need reasonable accommodation to access the information provided on this website, please contact recruiting@evolent.com for further assistance. The expected base salary/wage range for this position is $95-110/hr. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts. Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit
-
Urology Physician
7 months ago
Richmond, United States DocCafe Full timeDocCafe has an immediate opening for the following position: Physician - Urology in Richmond, Indiana.DocCafe is the premier physician and advanced practice job board to help you advance your healthcare career.----------------Register now to apply for this job and for access to 120,000+ other openings.DocCafe Offers:Free Physician and Advanced Practice Job...
-
Urology Physician Opportunity in Virginia
2 weeks ago
Richmond, California, United States Hayman Daugherty Associates, Inc Full timeJob OverviewWe are seeking a skilled Urology Physician to join our practice in Virginia.Salary and BenefitsThe estimated annual salary for this position is $400,000 - $600,000, depending on experience. Our benefits package includes comprehensive health insurance, retirement plan, paid time off, and continuing education opportunities.Job DescriptionThis busy...
-
Urology Physician
4 weeks ago
Richmond, United States SimplyApply Full timeUrology opening near Dayton, OH - Located in Richmond, IN - Dayton 45m; Indianapolis 70m; Columbus OH; 100m- Full Time; Employed- Permanent- BE/BC- Physician will be joining a group of three urologists, one uro/gyn, and four advanced practice providers- Base Salary of $500,000 for years then move to a productive model in year three- Signing Bonus of $60,000-...
-
Urology Physician
3 days ago
Richmond, United States Source Medical, LLC Full timeUrology opening near Dayton, OH - Located in Richmond, IN - Dayton 45m; Indianapolis 70m; Columbus OH; 100m- Full Time; Employed- Permanent- BE/BC- Physician will be joining a group of three urologists, one uro/gyn, and four advanced practice providers- Base Salary of $500,000 for years then move to a productive model in year three- Signing Bonus of $60,000-...
-
Urology Physician
3 days ago
Richmond, United States Britt Medical Search Full timeHighly regarded hospital group is recruiting a general urologist to join the growing urology practice. The potential physician will be joining a group of three urologists, one uro/gyn, and four advanced practice providers. Full-time hospital employed position Team: Join two urologists and five advanced practice providers DaVinci Robotics Clinic...
-
Urology Physician
3 days ago
Richmond, United States Goldfish Medical Staffing Full timeIndiana Urology OpportunityHospital employed group is seeking a BE/BC Urologist to join their well-established practice!The Practice: Well established practice, satellite locations, firm referral patterns DaVinci Robot training preferred! Excellent compensation plus productivity bonus paid quarterly based on w/RVUs $60K Signing Bonus, $100K Student Loan...
-
Physician Urology
4 weeks ago
Richmond, United States CompHealth Full timeRichmond has twice been the recipient of the All-America City Award in recognition of citizens who tackle community-wide challenges and achieve uncommon results. It offers a high-quality primary school system and excellent universities and colleges. The great outdoors await you with slot car racing, fossil hunting, roller skating, skate boarding, horseback...
-
Urology Physician
2 months ago
Richmond, IN, United States DocCafe Full timeDocCafe has an immediate opening for the following position: Physician - Urology in Richmond, Indiana. DocCafe is the premier physician and advanced practice job board to help you advance your healthcare career. ---------------- Register now to apply for this job and for access to 120,000+ other openings. DocCafe Offers: * Free Physician and Advanced...
-
Richmond, Virginia, United States Department of Veteran Affairs Full timeWe are seeking an experienced Urologist to join our dynamic team at the Department of Veteran Affairs in Fredericksburg, VA. As a valued member of our healthcare team, you will have the opportunity to work with patients who have made significant contributions to our nation.Job Summary: The selected candidate will be responsible for participating in and/or...
-
Urology Physician
1 day ago
Richmond, United States Arlington HealthCare Full timeJob ID: 8283Practice DetailsRecruiting a general urologist to join the growing urology practice.The potential physician will be joining a group of two urologists, one uro/gyn, and three advanced practice providers. DaVinci RoboticsLarge referral baseRecruiter's InsightMore Money. Starting Salary For Urology is $50,000 to $75,000 More Compared With Starting...
-
Urology Physician
4 weeks ago
Richmond, United States City Mobile Group, LLC Full timeCompany Overview:City Mobile Group is a leading locum tenens staffing firm, specializing in connecting healthcare professionals with temporary positions across various locations. We are dedicated to providing high-quality, flexible staffing solutions that meet the needs of healthcare facilities and professionals alike.Job Summary:We are seeking a qualified...
-
Urology Physician
1 month ago
Richmond, IN, United States Britt Medical Search Full timeHighly regarded hospital group is recruiting a general urologist to join the growing urology practice. The potential physician will be joining a group of three urologists, one uro/gyn, and four advanced practice providers. * Full-time hospital employed position * Team: Join two urologists and five advanced practice providers * DaVinci Robotics * Clinic...
-
Urology Physician
2 months ago
Richmond, United States City Mobile Group, LLC Full timeCompany Overview:City Mobile Group is a leading locum tenens staffing firm, specializing in connecting healthcare professionals with temporary positions across various locations.Any additional information you require for this job can be found in the below text Make sure to read thoroughly, then apply.We are dedicated to providing high-quality, flexible...
-
Urology Specialist
1 month ago
Richmond, California, United States Commonwealth of Virginia Full timeRole SummaryWe are seeking an accomplished Urology Specialist to join our team at the Commonwealth of Virginia, Department of Surgery. This is an exciting opportunity for a highly skilled professional to contribute to our mission of delivering exceptional urological care and advancing medical education.Key Responsibilities:Teach undergraduate and graduate...
-
CompHealth | Physician Urology
2 days ago
richmond, United States CompHealth Full timeRichmond has twice been the recipient of the All-America City Award in recognition of citizens who tackle community-wide challenges and achieve uncommon results. It offers a high-quality primary school system and excellent universities and colleges. The great outdoors await you with slot car racing, fossil hunting, roller skating, skate boarding, horseback...
-
CompHealth | Physician Urology
7 days ago
richmond, United States CompHealth Full timeRichmond has twice been the recipient of the All-America City Award in recognition of citizens who tackle community-wide challenges and achieve uncommon results. It offers a high-quality primary school system and excellent universities and colleges. The great outdoors await you with slot car racing, fossil hunting, roller skating, skate boarding, horseback...
-
Senior Urology Account Manager
1 week ago
Richmond, California, United States UroGen Full timeJob Title: Senior Urology Account ManagerWe are seeking a highly experienced Senior Urology Account Manager to join our team at UroGen. As a key member of our sales team, you will be responsible for establishing and maintaining strong relationships with urologists, administrators, and other key stakeholders in the urology community.About the Role:• Develop...
-
Clinical Review Nurse
2 weeks ago
Richmond, United States Centene Corporation Full timeYou could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. *Applicants for this role have the flexibility to work remotely from their home...
-
Licensed Practical Nurse
2 months ago
Richmond, United States Virginia Commonwealth University Health System Full time*$10,000 Sign on Bonus for offers accepted by December 31, 2024. Terms and conditions apply* The Urology Clinic is located on the 11th floor at the Adult Outpatient Pavilion and provides care to adult patients with cancer cases (bladder, kidney, prostate), various mobility issues and other urologic conditions and diseases. Our staff of RNs, LPNs, CMA and...
-
Pathology Anatomic and Clinical Physician
4 months ago
Richmond, United States HCA Physician Services Full timeDescription Specialization:Pathology HematopathologyPathology Anatomic and ClinicalJob Summary:HCA Healthcare Pathology Services and their Capital Division are seeking a general Pathologist to be based at Henrico Doctors Hospital which is located in Richmond, VA.HCA Healthcare Pathology Services employs over 200 board certified multispecialty pathologists...
