Your Future Evolves Here

Evolent collaborates with health plans and providers to improve outcomes for individuals facing complex and costly health issues. By connecting different specialties and primary care, we strive to reduce fragmentation in the healthcare system and ensure individuals receive the compassionate care they deserve.

At Evolent, we prioritize work/life balance, flexibility, and autonomy, believing that employees thrive when they are supported in their personal and professional lives. We are committed to fostering an inclusive environment where diversity is a core aspect of our operations.

Join Evolent for the mission; stay for the culture.

What You'll Be Doing:

You will play a critical role as a Medical Director in Radiation Oncology within our utilization management team, allowing you to make a significant impact on patient lives in a non-clinical setting. Enjoy an improved work-life balance while contributing to enhanced health outcomes in a collaborative and dynamic environment.

Collaboration Opportunities:
• Interact regularly with leadership, management staff, and fellow physicians for input on cases that require specialized medical expertise.

Key Responsibilities:
• Act as the Physician match reviewer for Radiation Oncology and imaging cases that do not meet medical necessity guidelines initially, as well as other specialty reviews mandated by providers or regulations.
• Engage in peer-to-peer discussions with requesting physicians regarding determinations and provide clinical rationale for standard and expedited appeals.
• Employ medical review guidelines to ensure consistency, adherence to SBU policies, and compliance with URAC and NCQA standards.
• Support Initial Clinical Reviewers by serving as a resource for inquiries and clarification.
• Document all communications with medical office staff and/or MD providers accurately and promptly.
• Assist the Senior Medical Director with research and inquiries related to the Utilization Management process, guidelines, and system support.
• Participate in ongoing training to maintain inter-rater reliability in the review process.

Qualifications:
• MD/DO/MBBS
• Five (5) years of medical practice post-residency, with active clinical practice within the last two years preferred.
• Current, unrestricted medical license in your specialty.
• Willingness to obtain and maintain licenses as required by business needs.
• Board Certified in Radiation Oncology.
• Strong clinical, management, communication, and organizational skills.
• Demonstrated energy and curiosity with a commitment to quality and value in healthcare.
• Proficiency in computer systems.
• Not excluded or sanctioned by any state or federal healthcare program and free from disciplinary actions by any state medical board.

For a secure hiring process, candidates will be subject to identity verification steps, background checks, in-person I-9 verification, and may undergo drug screening prior to employment. The use of AI tools during interviews is prohibited and monitored. Misrepresentation can lead to immediate disqualification from consideration.

Technical Requirements:

All employees must have high-speed internet (over 10 Mbps) at home, directly connected to their internet router.

Evolent is an equal opportunity employer, considering all qualified applicants regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status. If you require reasonable accommodation to access information on our website, please contact our recruitment team for assistance.

The anticipated base salary/wage range for this position is $130-$140/hr. Evolent offers comprehensive benefits (including health insurance) to eligible employees, with compensation based on required skills, experience, and individual qualifications.

If you don't see your ideal job listed, feel free to submit your contact information and resume; we will reach out if a fitting opportunity arises.