Field Medical Director-Vascular Surgery

Evolent • Trenton, NJ • 9h ago

Your Future Evolves Here

Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.

Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business.

Join Evolent for the mission. Stay for the culture.

What You'll Be Doing:

As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical environment. You can enjoy better work- life balance on a team that values collaboration and continuous learning while providing better health outcomes.

Collaboration Opportunities:

Routinely interacts with leadership and management staff, other Physicians, and staff whenever a physician`s input is needed or required.

What You Will Be Doing:

Serve as the specialty match reviewer in Vascular cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter expert.

Discusses determinations (peer to peer phone calls) with requesting physicians or ordering providers, when available, within the regulatory timeframe of the request.

Provides clinical rationale for standard and expedited appeals.

Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines.

Aids and acts as a resource to Initial Clinical Reviewers.

Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner.

Participates in on-going training per inter-rater reliability process.

May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support.

On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director.

Qualifications - Required and Preferred:

MD/DO/MBBS- Required

Minimum of five (5) years' experience in the practice of Vascular Surgeon- Preferred

Current, unrestricted clinical license in medicine or required specialty- Required

Obtaining and maintaining medical licenses in the state you reside- Required

Active Board Certification in Vascular Surgery or Active Board Certification in General Surgery with extensive experience in Vascular Surgery- Required

Strong clinical, management, communication, and organizational skills-Required

Energetic and curious with a passion for quality and value in health care-Required

Computer Proficiency-Required

To comply with HIPAA security standards (45 C.F.R. sec. 164.308 (a) (3)), identity verification may be required as part of the application process. This is collected for compliance and security purposes and only reviewed if an applicant advances to the final interview state. Reasonable accommodations are available upon request.

Technical Requirements:

We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.

Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status. If you need reasonable accommodation to access the information provided on this website, please contact recruiting@evolent.com for further assistance.

The expected base salary/wage range for this position is $120-$140/hr. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts.

Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!

Evolent

Go to Apply

Share this job

Similar Jobs

Postdoctoral Research Associate

Princeton University • Princeton, NJ • 1h ago

Hospital & Medical

Position: Postdoctoral Research Associate Description:Department of GeosciencesPRINCETON UNIVERSITY HARRY HESS FELLOWS PROGRAMThe Department of Geosciences at Princeton University announces competition for the 2026-2027...

1h ago

Go to Apply

RN Nurse Residency Program

BAYADA Home Health Care • Bensalem, PA • 6h ago

Hospital & Medical

Be the Nurse You Always Wanted to be at BAYADA We want you to flourish here - learning new skills, growing with every challenge, succeeding in each assignment, and advancing in your nursing career. BAYADA Offers : One on...

6h ago

Go to Apply

Sr. Manager, U.S. Monogastric Sales (Animal Nutrition)

Church & Dwight Co, Inc. • Trenton, NJ • 6h ago

Hospital & Medical

At Arm & Hammer Animal and Food Production we think big on a microscopic level to deliver safe feed and food solutions that drive businesses forward.We're nutritional innovators and microbial pioneers who have dedica...

6h ago

Go to Apply

Adult Live-In Caregiver / Home Health Aide

BAYADA Home Health Care • Langhorne, PA • 22h ago

Hospital & Medical

Work in your neighborhood and give back to your community. BAYADA Home Health Care has an immediate need for Live-In Caregivers / Home Health Aides to care for our clients. As a member of our home care team, you will be...

22h ago

Go to Apply

QAPI Nurse

Serenity Hospice Care • Fieldsboro, NJ • 1d ago

Hospital & Medical

Serenity Hospice provides caring and compassionate hospice care services to patients and families throughout New Jersey. Our mission is to alleviate pain and symptoms; foster a state of calmness and harmony; and encourag...

1d ago

Go to Apply

Data Scientist - Drug Discovery

Bristol Myers Squibb • Princeton, NJ • 1d ago

Hospital & Medical

Working with Us Challenging. Meaningful. Life-changing. Those aren't words that are usually associated with a job. But working at Bristol Myers Squibb is anything but usual. Here, uniquely interesting work happens every...

1d ago

Go to Apply

Nurse Practitioner

Genesis Healthcare • Langhorne, PA • 2d ago

Hospital & Medical

Overview Sub-Acute, Long-Term Care is a sector of healthcare exploding with potential and work-life balance flexibility (no on call or weekends)! We are seeking a full-time (40 hours per week) provider for our Crestview...

2d ago

Go to Apply

Physical Therapist

US Physical Therapy • Hamilton, NJ • 2d ago

Hospital & Medical

Company Description Hamilton Physical Therapy Services has been a well-established provider of rehabilitation services in Mercer County since 1978. "Physical Therapy by Physical Therapists'' is the motto our clinic lives...

2d ago

Go to Apply

Nursing Supervisor - Per Diem, Rotating Shifts (St. Mary)

Trinity Health • Langhorne, PA • 3d ago

Hospital & Medical

Employment Type: Part time Shift: Rotating Shift Description: St. Mary Medical Center, a member of Trinity Health Mid-Atlantic, is looking for a Nursing Supervisor to join our team! Schedule: Per diem, 12-hour rotating s...

3d ago

Go to Apply

Medical Malpractice Paralegal

Robert Half • Yardley, PA • 3d ago

Hospital & Medical

Description Our distinguished client is seeking a dedicated Medical Malpractice Paralegal to join our team in Yardley, Pennsylvania. This position offers the chance to work in a dynamic legal environment where your exper...

3d ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.