Evernorth Health Services
Medical Director - Pediatric Otolaryngology - EviCore
Evernorth Health Services, South Bloomfield, Ohio, United States
Overview
Medical Director - Pediatric Otolaryngology - EviCore at Evernorth Health Services. This role involves using clinical expertise to provide evidence-based medical reviews for patient care, collaborating with healthcare providers, and staying current on healthcare regulations and industry developments. We are seeking a detail-oriented individual with strong communication, technology, and typing skills, as well as solid clinical judgment. This position offers the opportunity to develop new skills within an innovative team. Responsibilities
You’ll start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success. Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on EviCore’s case management software. Conduct physician consultations (peer-to-peer) with referring providers to discuss evidence-based medical necessity and appropriateness of the requested service or treatment. Leverage clinical expertise to recommend alternative services or treatments as necessary. Collaborate with over 500 EviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making.
What you’ll enjoy about working here
Benefits start on day one Predictable work schedules 100% work from home 8 paid holidays + 23 PTO days 401(k) with company match Reimbursement for continuing medical education Career growth opportunities across the enterprise Networking with peers across multiple medical specialties
Requirements
M.D. or D.O. with a current, active U.S. state medical license and board certified in Pediatric Otolaryngology (ABMS or AOA) Eligible to acquire additional state licensure as required Preferred one of: DC, MD or VA license 3+ years of relevant clinical experience post residency/fellowship Knowledge of applicable state and federal laws Utilization Review Accreditation Commission and National Committee for Quality Assurance standards is a plus Ability to commit to a set, weekly work schedule (Monday through Friday) Strong computer skills and ability to work autonomously with automated processes and systems Ability to meet the physical demands of the role, including typing, speaking, and listening continuously Company-provided encrypted workstation required to be hard-wired; wireless connection not permitted
If you will be working at home occasionally or permanently, the internet connection must be through a cable broadband or fiber optic provider with speeds of at least 10 Mbps download / 5 Mbps upload.
Salary range anticipated for this position is 203,200 – 338,600 USD per year, depending on experience and geographic location. The role may be eligible for an annual bonus plan.
Benefits and About Evernorth Health Services
Starting on day one, employees are offered comprehensive health-related benefits including medical, vision, dental, and well-being/behavioral health programs. We offer 401(k) with company match, company-paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, and paid holidays. For more details, visit Life at Cigna Group. Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and vitality.
Qualified applicants will be considered without regard to race, color, age, disability, sex, pregnancy or related medical conditions, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, or other protected characteristics. If you require reasonable accommodation in completing the online application process, please email SeeYourself@cigna.com for support. The Cigna Group maintains a tobacco-free policy where allowed by law. Candidates must not use tobacco/nicotine where prohibited. Qualified applicants with criminal histories will be considered in accordance with applicable laws.
Additional details
Seniority level: Not Applicable Employment type: Full-time Job function: Health Care Provider Industries: Insurance
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Medical Director - Pediatric Otolaryngology - EviCore at Evernorth Health Services. This role involves using clinical expertise to provide evidence-based medical reviews for patient care, collaborating with healthcare providers, and staying current on healthcare regulations and industry developments. We are seeking a detail-oriented individual with strong communication, technology, and typing skills, as well as solid clinical judgment. This position offers the opportunity to develop new skills within an innovative team. Responsibilities
You’ll start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success. Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on EviCore’s case management software. Conduct physician consultations (peer-to-peer) with referring providers to discuss evidence-based medical necessity and appropriateness of the requested service or treatment. Leverage clinical expertise to recommend alternative services or treatments as necessary. Collaborate with over 500 EviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making.
What you’ll enjoy about working here
Benefits start on day one Predictable work schedules 100% work from home 8 paid holidays + 23 PTO days 401(k) with company match Reimbursement for continuing medical education Career growth opportunities across the enterprise Networking with peers across multiple medical specialties
Requirements
M.D. or D.O. with a current, active U.S. state medical license and board certified in Pediatric Otolaryngology (ABMS or AOA) Eligible to acquire additional state licensure as required Preferred one of: DC, MD or VA license 3+ years of relevant clinical experience post residency/fellowship Knowledge of applicable state and federal laws Utilization Review Accreditation Commission and National Committee for Quality Assurance standards is a plus Ability to commit to a set, weekly work schedule (Monday through Friday) Strong computer skills and ability to work autonomously with automated processes and systems Ability to meet the physical demands of the role, including typing, speaking, and listening continuously Company-provided encrypted workstation required to be hard-wired; wireless connection not permitted
If you will be working at home occasionally or permanently, the internet connection must be through a cable broadband or fiber optic provider with speeds of at least 10 Mbps download / 5 Mbps upload.
Salary range anticipated for this position is 203,200 – 338,600 USD per year, depending on experience and geographic location. The role may be eligible for an annual bonus plan.
Benefits and About Evernorth Health Services
Starting on day one, employees are offered comprehensive health-related benefits including medical, vision, dental, and well-being/behavioral health programs. We offer 401(k) with company match, company-paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, and paid holidays. For more details, visit Life at Cigna Group. Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and vitality.
Qualified applicants will be considered without regard to race, color, age, disability, sex, pregnancy or related medical conditions, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, or other protected characteristics. If you require reasonable accommodation in completing the online application process, please email SeeYourself@cigna.com for support. The Cigna Group maintains a tobacco-free policy where allowed by law. Candidates must not use tobacco/nicotine where prohibited. Qualified applicants with criminal histories will be considered in accordance with applicable laws.
Additional details
Seniority level: Not Applicable Employment type: Full-time Job function: Health Care Provider Industries: Insurance
#J-18808-Ljbffr