Physician / Oncology / Arizona / Permanent / Associate Medical

About the role

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.

Responsibilities

• Provide 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.
• Review appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.
• Provide timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.
• Maintain necessary credentials and immediately inform eviCore of any adverse actions relating to medical licenses and/or board certifications.
• Participate in strategic planning for and evaluation of the Care Management.

Requirements

• M.D. or D.O. with a current, active, U.S. state medical license.
• Board certified in Oncology, recognized by the American Board of Medical Specialties (ABMS).
• Recent practice experience in direct patient care (within the past 18 months).
• Minimum of 5 years clinical experience, beyond residency/fellowship.
• Familiarity with automated processes and computer applications and systems is required.

Qualifications

• Knowledge of applicable state and federal laws, URAC and NCQA standards a plus.

Schedule

• No nights, no weekends, no call.
• Predictable work schedule.
• Full and part time opportunities.

Benefits

Salaried position with benefits. Supportive organization with collaborative culture. eviCore 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 opportunities.
• 4 weeks of PTO (starting) per year plus paid holidays.
• One week of CME.
• Education assistance, tuition reimbursement and professional certifications.
• Health, dental, vision, and life benefits with employer funded HSA.
• Paid Volunteer Community Service Days.
• Ample opportunities for growth, advancement, and promotion.
• 401k retirement plan with company match of 50% employee contributions up to 6%.