Medical Director - Pathology - EviCore

The Cigna Group

1d•$207,800 - $346,300•Remote

About The Position

The job profile for this position is Utilization Review Medical Principal, which is a Band 5 Senior Contributor Career Track Role. We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. Do you crave an intellectually stimulating role that lets you apply your clinical expertise while continuing to grow and make an impact? As a Medical Director at EviCore, part of Evernorth Health Services, a division of The Cigna Group, you’ll leverage your background in pathology—including Anatomic Pathology, Clinical Pathology, Cytopathology, Dermatopathology, Hematopathology, Molecular Genetic Pathology, or Neuropathology to deliver evidence-based medical reviews that support high-quality patient care. Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases. This role offers you the opportunity to build new skills while enhancing the health and vitality of others. We're seeking a detail-oriented individual with good communication, technology, and typing skills, as well as strong clinical judgment. Drive growth in your career with our innovative team.

Requirements

M.D. or D.O. with a current, active U.S. medical license and board certification (ABMS or AOA) in one or more of the following: Anatomic Pathology, Clinical Pathology, Cytopathology, Dermatopathology, Hematopathology, Molecular Genetic Pathology, or Neuropathology.
Eligible to acquire additional state licensure as required
Clinical experience required
3 years of relevant clinical experience post residency/fellowship
Ability to commit to a set, weekly work schedule (Monday through Friday)
Strong computer skills: ability to work autonomously with automated processes, computer applications, and systems
Meet physical demands of the role including, but not limited to, typing, speaking, and listening 100% of time
In accordance with our HITECH Security Accreditation, company provided encrypted-workstation is required to be hard-wire connected to a modem or router. Wireless connection is not permitted.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Nice To Haves

Knowledge of applicable state and federal laws, Utilization Review Accreditation Commission and National Committee for Quality Assurance standards is a plus

Responsibilities

Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on EviCore’s case management software.
Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence–based medical necessity and appropriateness of the requested service or treatment.
Leverage your clinical expertise to recommend alternative services or treatments as necessary.
Work collaboratively with over 500 EviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making.