Physician / Oncology / Nationwide / Permanent / Associate Medical Director - Oncology - 100% Remote

Medical Reviewer

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.

Job Description

• 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.