Physician / Surgery
Company: eviCore healthcare
Posted on: September 9, 2023
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
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
Maintains necessary credentials and immediately informs eviCore of
any adverse actions relating to medical licenses and/or board
Participates in strategic planning for and evaluation of the Care
The successful candidate will be an M.D. or D.O. with a current,
active, U.S. state medical license and board certified in Surgery -
Orthopedics, recognized by the American Board of Medical
Specialties (ABMS), with recent practice experience in direct
patient care (within the past 18 months).
Must have a minimum of 5 years clinical experience, beyond
Knowledge of applicable state and federal laws, URAC and NCQA
standards a plus, and familiarity with automated processes and
computer applications and systems is required
No nights, no weekends, not call.
Predictable work schedule
Full and part time opportunities
Salaried position with benefits
Supportive organization with collaborative culture
eviCore healthcare is committed to making a positive impact on
healthcare, and also making a positive impact on our employees.
eviCore offers a variety of perks and benefits including, but not
Flexible scheduling and work/life balance with remote and work from
4 weeks of PTO(starting) per year plus paid holidays
One week of CME
Education assistance, tuition reimbursement and professional
Health, dental, vision, and life benefits with employer funded
Paid Volunteer Community Service Days
Ample opportunities for growth, advancement, and promotion
401k retirement plan with company match of 50% employee
contributions up to 6%
eviCore is committed to hiring and retaining a diverse workforce.
We are an Equal Opportunity Employer, making decisions without
regard to race, color, religion, sex, national origin, age, veteran
status, disability, or any other protected class. Applicants must
be able to pass a drug test and background investigation
Keywords: eviCore healthcare, Riverside , Physician / Surgery , Other , Riverside, California
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