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Field Medical Director, Radiation Oncology Specialist
1 hour ago
Your Future Evolves Here
Evolent partners with health plans and providers to achieve better outcomes for individuals facing the most complex and costly health conditions. By working across various specialties and primary care, we aim to connect the fractured pieces of the healthcare system, ensuring that everyone receives the same level of care and compassion we would want for our loved ones.
At Evolent, we value work/life balance, flexibility, and autonomy, believing that our employees perform best when they are empowered to lead fulfilling lives. This is why we prioritize diversity and inclusion as fundamental aspects of our business.
Join Evolent for the mission. Stay for the culture.
What You'll Be Doing:
In the role of Field Medical Director, you will be a vital member of our utilization management team. This position offers a meaningful opportunity to positively impact patients' lives in a non-clinical setting, allowing you to enjoy a better work-life balance while contributing to improved health outcomes through collaboration and continuous learning.
Collaboration Opportunities:
- Engage regularly with leadership, management, other physicians, and staff whenever expert input is required.
What You Will Be Doing:
- Act as the primary physician reviewer for Radiation Oncology cases that do not initially meet medical necessity guidelines, as well as other imaging requests that necessitate specialty reviews by an expert.
- Conduct peer-to-peer discussions with requesting physicians or ordering providers, within the regulatory timeframe, providing clinical rationale for standard and expedited appeals.
- Employ medical and clinical review guidelines to maintain consistency in the review process while ensuring compliance with organizational policies and regulatory standards (URAC, NCQA).
- Serve as a resource and support for Initial Clinical Reviewers.
- Document all communications with medical office staff and/or providers in a timely and accurate manner.
- Assist the Senior Medical Director with research activities or questions related to the Utilization Management process and guidelines.
- Participate in ongoing training to ensure inter-rater reliability.
Qualifications:
- MD/DO/MBBS required.
- A minimum of five (5) years of post-residency medical practice experience, with active clinical practice within the last 2 years preferred.
- Current, unrestricted clinical license in medicine or specialty required.
- Active Board Certification in Radiation Oncology.
- Strong clinical, management, communication, and organizational skills.
- Motivated and engaged with a commitment to delivering quality and value in healthcare.
- Proficient in computer skills.
- Not excluded or sanctioned by any state or federal health care program, including Medicare or Medicaid.
- No history of major disciplinary or legal actions by a state medical board.
To maintain a secure hiring process, we implement identity verification steps including the submission of a government-issued photo ID. We also conduct thorough background checks, in-person I-9 verification, and may require drug screening prior to employment. The use of artificial intelligence tools during the interview process is prohibited and monitored, and any misrepresentation will result in immediate disqualification from consideration.
Technical Requirements:
All employees must ensure they have high-speed internet access of at least 10 Mbps and, for call center positions, the ability to connect directly to their home internet router. These requirements may change in accordance with future office reopening plans.
Evolent is an equal opportunity employer, considering all qualified applicants 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, please contact recruiting@evolent.com for further assistance.
The expected base hourly rate for this position is $130-140/hr, with eligibility for performance-based bonuses. Evolent offers a comprehensive benefits package to qualifying employees, and compensation is based on the required skills and experience for the position. This may vary above or below the stated amounts based on selected candidates.
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