Evernorth Health Services
Medical Director – Clinical Genetics/Pathology – EviCore
Evernorth Health Services, South Bloomfield, Ohio, United States
Overview
Medical Director – Clinical Genetics/Pathology – EviCore, part of Evernorth Health Services, a division of The Cigna Group. The 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. Responsibilities
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 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. 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
MD or DO with a current, active US state medical license and board certification in Clinical Genetics or Pathology recognized by the American Board of Medical Specialties or American Osteopathic Association Eligible to acquire additional state licensure as required 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: 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 the time Company-provided encrypted workstation is required to be hard-wired 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 provider with speeds of at least 10Mbps download/5Mbps upload. For this position, annual salary is anticipated at 203,200 - 338,600 USD per year, depending on experience and geographic location. This role is anticipated to be eligible to participate in an annual bonus plan. We offer a comprehensive range of benefits starting on day one, including medical, vision, dental, and well-being programs, 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. About Evernorth Health Services: Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. Qualified applicants will be considered without regard to race, color, age, disability, sex, pregnancy or related conditions, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where legally permissible. Candidates in such states who use tobacco/nicotine will not be considered unless they enter a qualifying cessation program prior to start. Qualified applicants with criminal histories will be considered in accordance with all applicable laws. Job details
Seniority level: Not Applicable Employment type: Full-time Job function: Health Care Provider Industries: Hospitals and Health Care
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Medical Director – Clinical Genetics/Pathology – EviCore, part of Evernorth Health Services, a division of The Cigna Group. The 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. Responsibilities
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 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. 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
MD or DO with a current, active US state medical license and board certification in Clinical Genetics or Pathology recognized by the American Board of Medical Specialties or American Osteopathic Association Eligible to acquire additional state licensure as required 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: 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 the time Company-provided encrypted workstation is required to be hard-wired 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 provider with speeds of at least 10Mbps download/5Mbps upload. For this position, annual salary is anticipated at 203,200 - 338,600 USD per year, depending on experience and geographic location. This role is anticipated to be eligible to participate in an annual bonus plan. We offer a comprehensive range of benefits starting on day one, including medical, vision, dental, and well-being programs, 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. About Evernorth Health Services: Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. Qualified applicants will be considered without regard to race, color, age, disability, sex, pregnancy or related conditions, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where legally permissible. Candidates in such states who use tobacco/nicotine will not be considered unless they enter a qualifying cessation program prior to start. Qualified applicants with criminal histories will be considered in accordance with all applicable laws. Job details
Seniority level: Not Applicable Employment type: Full-time Job function: Health Care Provider Industries: Hospitals and Health Care
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