Field Medical Director, Interventional Cardiology (Remote)

What You’ll Be Doing

• Provide expert reviews for cardiovascular cases, serving as a specialty-matched expert reviewer for invasive/interventional cardiology cases (e.g., cardiac catheterizations, coronary interventions, endovascular procedures, implantable cardiac devices, etc) that do not initially meet medical necessity guidelines or require further evaluation by a subject matter expert.
• Conduct peer-to-peer discussions with treating providers to ensure appropriate, high-value care aligned with clinical guidelines.
• Collaborate with leadership, management, and clinical staff to address complex cases and support decision-making.
• Act as a key resource for Initial Clinical Reviewers, offering guidance and expertise to ensure the application of best practices.
• Provides clinical rationale for standard and expedited appeals.
• Discusses determinations (peer to peer phone calls) with requesting physicians or ordering providers, when available, within the regulatory timeframe of the request.
• Utilizes 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.
• Safeguards documentation of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner.
• Participates in on-going training per inter-rater reliability process.
• Might assist the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support.
• On a requested basis, might function as Medical Director for selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director.

  What We Offer

  • A meaningful way to contribute to patient care beyond the clinical setting.
  • Opportunities for collaboration with a dynamic team of physicians, leaders, and clinical professionals.
  • A role that values innovation, continuous improvement, and clinical excellence.
  • This position is 100% Remote and can be completed from any state.
  • Multiple opportunities for a flexible schedule and both part-time and full-time options available.

    Qualifications

    • MD/DO/MBBS Degree
    • Current, unrestricted clinical license in medicine or required specialty
    • Obtaining and maintaining medical licenses in the state you reside, as well as, other state licensure required per business needs
    • Active Board Certification in Interventional Cardiology or may be substituted for one of the following:
      • Active Board Certification in Cardiology and proof of prior board certification in Interventional Cardiology
      • Active Board Certification in Cardiology and proof of active practice as an Interventional Cardiologist for 5+ years
    • Strong clinical, management, communication, and organizational skills
    • Energetic and curious with a passion for quality and value in health care
    • Computer Proficiency
      • Minimum of five (5) years’ experience in the practice of Cardiology is preferred
      • No history of a major disciplinary or legal action by a state medical board
    • To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance.
    • All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment.
    • The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration.
    • 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.
    • 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 recruitingteam@evolent.com for further assistance.
    • The expected base salary/wage range for this position is $120-$140/hr.
    • 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 experience of selected individuals, which may vary above and below the stated amounts.