Clinical Leader in Radiation Oncology

7 days ago


Topeka, Kansas, United States Evolent Full time
Clinical Expertise Wanted

We're seeking a skilled Field Medical Director to enhance our patient care services.

Evolent partners with health plans and providers to achieve better outcomes for people with complex and costly health conditions. As a Field Medical Director, you will be part of our utilization management team, working across specialties and primary care to ensure seamless care delivery.

Responsibilities:

  • Serve as the Physician match reviewer in Radiation Oncology and imaging cases that do not initially meet the applicable medical necessity guidelines.
  • Discuss determinations with requesting physicians or ordering providers, when available, within the regulatory timeframe of the request and provide clinical rationale for standard and expedited appeals.

You will utilize medical/clinical review guidelines and parameters to ensure consistency in the MD review process. 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.

Qualifications:

MD/DO/MBBS
Minimum of five (5) years' experience in the practice of Medicine, post-residency, and 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.


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