Field Medical Director-Radiation Oncology

Evolent; Salem (OR); Remote; USD 100,000 - 125,000; Full time

Job summary

A healthcare organization in Salem, Oregon is seeking a qualified physician to join their utilization management team. The role requires an MD/DO and experience in medicine, specifically in Radiation Oncology. Responsibilities include peer-review discussions and ensuring compliance with medical guidelines. This position offers a competitive hourly rate between $115-$130 and includes comprehensive benefits and a bonus component based on performance.

Benefits

Comprehensive health insurance

Work/life balance

Flexible schedule

Qualifications

• Minimum of five years’ experience in the practice of Medicine.
• Active clinical practice within the last 2 years is preferred.
• Current, unrestricted clinical license in medicine or required specialty.

Responsibilities

• Serve as the Physician match reviewer in Radiation Oncology.
• Discuss determinations with requesting physicians.
• Utilize medical review guidelines to assure consistency.

Skills

Clinical expertise

Communication skills

Organizational skills

Management skills

Computer proficiency

Education

MD/DO/MBBS

Active Board Certification in Radiation Oncology

Job description

Overview

Evolent partners with health plans and providers to achieve better outcomes for people with the most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of the fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.

Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business.

Join Evolent for the mission. Stay for the culture.

What You’ll Be Doing

As a FMD, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients’ lives, in a non-clinical environment. You can enjoy better work-life balance on a team that values collaboration and continuous learning while providing better health outcomes.

Responsibilities

• Serve as the Physician match reviewer in Radiation Oncology and imaging cases that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter expert.
• Discuss determinations (peer-to-peer conversations) with requesting physicians or ordering providers within the regulatory timeframe and provide clinical rationale for standard and expedited appeals.
• Utilize 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 URAC and NCQA guidelines.
• Aid and act as a resource to Initial Clinical Reviewers.
• Ensure documentation of all communications with medical office staff and/or MD providers is recorded in a timely and accurate manner.
• May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support.
• Participate in ongoing training per inter-rater reliability process.

Qualifications

• MD/DO/MBBS
• Minimum of five (5) years’ experience in the practice of Medicine, post residency and active clinical practice within the last 2 years is preferred
• Current, unrestricted clinical license in medicine or required specialty
• Obtaining and maintaining medical licenses in the state you reside, as well as any license required per business needs
• Active Board Certification in Radiation Oncology
• Strong clinical, management, communication, and organizational skills
• Energetic and curious with a passion for quality and value in health care
• Computer proficiency

To comply with HIPAA security standards (45 C.F.R. 164.308(a)(3)), identity verification may be required as part of the application process. This is collected for compliance and security purposes and only reviewed if an applicant advances to the final interview state. Reasonable accommodations are available upon request.

Technical Requirements

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. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.

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 [e-mail] for further assistance.

The expected base salary/wage range for this position is $115-$130/hr. This position is also eligible for a bonus component that would be dependent on predefined performance factors. 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.

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