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Physician / Surgery - Orthopedics / Nationwide / Permanent / Associate Medical Director - Orthopedic Surgery - 100% Remote Job Job

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eviCore healthcare

2024-07-02 02:45:10

Job location Not Provided, Not Provided, United States

Job type: fulltime

Job industry: Healthcare & Medical

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 Management

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