Medical Director for Maternal Care Management
5 days ago
eviCore healthcare is seeking an experienced Medical Director to lead our Maternal Care Management team. This is a full-time salaried position with benefits, offering a predictable work schedule and opportunities for growth.
Key Responsibilities- Provide timely expert medical review for services not meeting utilization review criteria.
- Evaluate appeals for denied services related to current relevant medical experience or knowledge.
- Engage in peer-to-peer discussions with referring physicians to clarify clinical information and explain review outcome decisions.
- Maintain necessary credentials and inform eviCore of any adverse actions relating to medical licenses and/or board certification.
- MD or DO degree with a current, active U.S. state medical license.
- Board certified in Maternal-Fetal Medicine, recognized by the American Board of Medical Specialties (ABMS).
- Recent practice experience in direct patient care within the past 18 months.
- A minimum of 5 years clinical experience beyond residency/fellowship.
- Familiarity with applicable state and federal laws, URAC and NCQA standards, and automated processes and computer applications.
- Predictable work schedule with no nights, weekends, or call.
- Salaried position with benefits, including health, dental, vision, and life insurance.
- 4 weeks of PTO per year plus paid holidays.
- Education assistance, tuition reimbursement, and professional certifications.
- Opportunities for growth, advancement, and promotion.
$150,000 - $200,000 per year, depending on experience.
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