PHYSICIAN / GASTROENTEROLOGY / PENNSYLVANIA / PERMANENT / ASSOCIATE MEDICAL DIRECTOR - GASTRO - 100%
Company: eviCore healthcare
Location: Philadelphia
Posted on: September 28, 2024
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Job Description:
Provides timely expert medical review for requests to evaluate
the medical necessity of services that do not meet utilization
review criteria while located in a state or territory of the United
States.Reviews appeals for denied services related to current
relevant medical experience or knowledge in accordance with appeal
policies, if so delegated.Provides timely peer-to-peer discussions
with referring physicians to clarify clinical information and to
explain review outcome decisions.Maintains necessary credentials
and immediately informs eviCore of any adverse actions relating to
medical licenses and/or board certifications.Participates in
strategic planning for and evaluation of the Care ManagementThe
successful candidate will be an M.D. or D.O. with a current,
active, U.S. state medical license and board certified in
Gastroenterology, recognized by the American Board of Medical
Specialties (ABMS), with recent practice experience in direct
patient care (within the past 18 months).Must have a minimum of 5
years clinical experience, beyond residency/fellowship Knowledge of
applicable state and federal laws, URAC and NCQA standards a plus,
and familiarity with automated processes and computer applications
and systems is requiredNo nights, no weekends, not call.Predictable
work scheduleFull and part time opportunitiesSalaried position with
benefitsSupportive organization with collaborative cultureeviCore
healthcare is committed to making a positive impact on healthcare,
and also making a positive impact on our employees. eviCore offers
a variety of perks and benefits including, but not limited
to:Flexible scheduling and work/life balance with remote and work
from home opportunities4 weeks of PTO(starting) per year plus paid
holidaysOne week of CMEEducation assistance, tuition reimbursement
and professional certifications Health, dental, vision, and life
benefits with employer funded HSAPaid Volunteer Community Service
Days Ample opportunities for growth, advancement, and promotion
401k retirement plan with company match of 50% employee
contributions up to 6% eviCore is committed to hiring and retaining
a diverse workforce. We are an Equal Opportunity Employer, making
decisions without regard to race, color, religion, sex, national
origin, age, veteran status, disability, or any other protected
class. Applicants must be able to pass a drug test and background
investigation
Keywords: eviCore healthcare, Philadelphia , PHYSICIAN / GASTROENTEROLOGY / PENNSYLVANIA / PERMANENT / ASSOCIATE MEDICAL DIRECTOR - GASTRO - 100%, Executive , Philadelphia, Pennsylvania
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