Field Medical Director-Pulmonology
5 days ago
Evolent partners with health plans and providers to achieve better outcomes for people with the most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of the 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 the 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 Field Medical Director, 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.
- Routinely interact with leadership and management staff, other Physicians, and staff whenever a physician's input is needed or required.
- 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.
- Discuss determinations (peer to peer phone calls) with requesting physicians or ordering providers, when available, within the regulatory timeframe of the request and provide clinical rationale for standard and expedited appeals.
- Utilize 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.
- 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.
- May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines, and/or system support.
- 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, and Active Clinical practice within the last 2 years is preferred
- Current, unrestricted clinical license in medicine or required specialty
- Obtaining and maintaining medical licenses in the state you reside, as well as any license required per business needs
- Active Board Certification in Pulmonology
- Strong clinical, management, communication, and organizational skills
- Energetic and curious with a passion for quality and value in health care
- 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 $94-105/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 the experience of selected individuals, which may vary above and below the stated amounts.
#J-18808-Ljbffr-
Field Medical Director-Pulmonology
2 days ago
Nashville, United States Evolent Full timeEvolent Field Medical Director-Pulmonology Nashville, Tennessee Apply NowEvolent partners with health plans and providers to achieve better outcomes for people with the most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of the fragmented health care system and ensure people get the same level...
-
Medical Director in Pulmonology
24 hours ago
Nashville, Tennessee, United States Evolent Full timeAbout the Role">Evolent is seeking a seasoned Medical Director in Pulmonology to join our team. As a key member of our utilization management team, you will play a critical role in making a meaningful difference in patients' lives.In this position, you will work closely with leadership and management staff, other physicians, and staff to provide expert...
-
Pulmonologist Field Medical Lead
20 hours ago
Nashville, Tennessee, United States Evolent Full timePulmonologist Field Medical LeadEvolent seeks a highly skilled Pulmonologist Field Medical Lead to join our team. In this position, you will leverage your expertise to drive quality and value in healthcare.Your responsibilities will include:">Providing clinical guidance and support to leaders and staff">Serving as a subject matter expert in imaging...
-
Field Medical Director-ENT
5 days ago
Nashville, United States Evolent Full timeEvolent Field Medical Director-ENT Nashville, Tennessee Apply NowEvolent partners with health plans and providers to achieve better outcomes for people with the most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care systems and ensure people get the same level of care...
-
Field Medical Director-ENT
2 days ago
Nashville, United States Evolent Full timeEvolent Field Medical Director-ENT Nashville, Tennessee Apply NowEvolent partners with health plans and providers to achieve better outcomes for people with the most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care systems and ensure people get the same level of care...
-
Nashville, Tennessee, United States Medicorp, Inc Full timeWe are seeking a highly skilled Pediatric Pulmonologist to join our team at Medicorp, Inc in Northeastern Tennessee. This full-time position offers a 100% pediatric pulmonology opportunity with teaching and research possibilities.About the RoleThe ideal candidate will have expertise in pediatric pulmonology and a passion for delivering high-quality patient...
-
Field Medical Director, Genetic Testing
2 days ago
Nashville, United States Evolent Full timeEvolent Field Medical Director, Genetic Testing Nashville, Tennessee Apply NowEvolent partners with health plans and providers to achieve better outcomes for people with the most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of the fragmented health care system and ensure people get the same...
-
Director of Field Services
2 weeks ago
Nashville, Tennessee, United States Vector Security, Inc. Full timeJob SummaryThe Director of Field Services will lead the efficient management of the field staff in installing, servicing, supporting, and repairing security, fire, CCTV, and access control systems.This role will directly supervise and coordinate the activities of installation and service supervisors as well as the warehouse coordinator.Main...
-
Track and Field Program Director
3 weeks ago
Nashville, Tennessee, United States Valor Collegiate Academies Full timeJob OverviewWe are seeking a highly motivated and experienced Track and Field Program Director to lead our Middle School Boys Track & Field team. As a key member of our Athletic Department, you will be responsible for developing and implementing a comprehensive training program that fosters the growth and success of our student-athletes.This is a great...
-
Locum physician
4 weeks ago
Nashville, United States Barton Associates Full timeJob Details Start Date: Early May 2025 Schedule : 8a - 5p shifts from Mondays - Fridays Responsibilities: • Asthma • Cystic fibrosis • Sleep apnea • Bronchopulmonary dysplasia • Other pediatric pulmonology cases/procedures Additional Information: • Potential for assignment extension • EMR System: Epic Apply today to learn more! Benefits: Strong...
-
Nashville, Tennessee, United States Physician Empire Full timeAbout the JobWe are seeking a skilled Pulmonologist to join our team at Physician Empire in the Memphis metro area. This is an excellent opportunity for a Board Certified or Eligible physician to grow their career and make a meaningful impact on patient care.Job HighlightsCompetitive salary: $275,000 per yearNo call requirements (outpatient...
-
Nashville, United States Locum Jobs Online Full timeLocumJobsOnline is working with Barton Associates to find a qualified Pulmonology MD in Tennessee! About The Position Job Details Start Date: Early May 2025 Schedule : 8a - 5p shifts from Mondays - Fridays Responsibilities: •Asthma •Cystic fibrosis •Sleep apnea •Bronchopulmonary dysplasia •Other pediatric pulmonology cases/procedures Additional...
-
Locum Physician
1 month ago
Nashville, United States Barton Associates Full timeJob DetailsStart Date: Early May 2025Schedule: 8a - 5p shifts from Mondays - FridaysResponsibilities:•Asthma•Cystic fibrosis•Sleep apnea•Bronchopulmonary dysplasia•Other pediatric pulmonology cases/proceduresAdditional Information:•Potential for assignment extension•EMR System: EpicApply today to learn more!Benefits:Strong...
-
Field Service Director
5 days ago
Nashville-Davidson, United States GovCIO Full timeGovCIO is currently hiring for a remote Field Service Director.ResponsibilitiesDirects and oversees field services activities within an organization.Plans and develops policies and procedures for on-site installation, testing, maintenance, and troubleshooting.Ensures all field service projects are completed within budget/deadline to meet customers'...
-
Medical Director for Complex Health Care
24 hours ago
Nashville, Tennessee, United States Evolent Full timeEvolent Field Medical Director-ENT OpportunityWe partner with health plans and providers to deliver exceptional outcomes for individuals with complex health conditions.As a Field Medical Director, you will be part of our utilization management team. You will have the opportunity to make a meaningful difference in patients' lives in a non-clinical...
-
Medical Director Opportunity in Tennessee
3 weeks ago
Nashville, Tennessee, United States Adaptive Medical Partners Full timeWe are seeking a medical director to lead an established practice in Tennessee. The ideal candidate will have experience in family medicine and a passion for patient care.Key HighlightsEstimated salary: $150,000 - $200,000 per year, depending on experienceSign-on bonus of $50,000Possible partnership or buy-in opportunityThe practice offers a traditional...
-
Medical Director of Psychiatry
3 weeks ago
Nashville, Tennessee, United States TriStar Centennial Medical Center Full timeJob Title:Medical Director of PsychiatryAbout the Role:This is a full-time opportunity for an experienced Psychiatrist to lead a 31-resident psychiatry program in Nashville, TN. The ideal candidate will have expertise in adult psychiatry and research.Responsibilities:Practice and teach full-spectrum adult psychiatryProvide clinical supervision of...
-
Associate Medical Director
2 weeks ago
Nashville, Tennessee, United States TriStar Centennial Medical Center Full timeTriStar Centennial Medical Center is seeking a talented and experienced psychiatrist to fill the position of Associate Program Director. As an Associate Program Director, you will be responsible for providing clinical supervision, teaching didactics, and leading curriculum development. You will also serve as an advisor and role model to our residents.About...
-
Nashville, Tennessee, United States ICON Medical Network Full timeJob OverviewWe are seeking a seasoned Medical Director to lead our outpatient clinic in Tennessee. As a key member of our team, you will be responsible for overseeing the medical aspects of our clinic, ensuring seamless operations and high-quality patient care.
-
Medical Director
3 weeks ago
Nashville, Tennessee, United States Adaptive Medical Partners Full timeWe are seeking a Medical Director to join our team at Adaptive Medical Partners. This is an exciting opportunity for a highly skilled and experienced physician to lead our hematology/oncology department.About the Role:As a Medical Director, you will be responsible for overseeing the clinical operations of our hematology/oncology department, ensuring...