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• Job Description Summary
Guides the company on strategic Utilization Review decisions and provides medical advice that has a significant impact on strategic planning and patient treatment. Widely recognized Medical Direction expert and thought leader by both internal and external community. Provides professional guidance and assistance in the evaluation of medical factors of proposed risks. Establishes research parameters and maintains a system/process that evaluates the quality and medical utilization of members. May prescribe procedures and provide interpretations of laboratory, EKG, and X-ray results involved in risk appraisal. Establishes and implements policies and standards, evaluate new treatments, and conduct medical research to ensure the quality of the medical care provided to patients. Implements utilization and financial initiatives. Responsible for program execution and drives utilization review medical program management for specific clinical programs. Develops and manages efforts to improve and maintain cost and utilization trends. Requires an MD, DO or DC.
Hiring Requirements
Job Details
• Do you crave an intellectually stimulating job that allows you to leverage your clinical expertise while developing new skills and improving the lives of others? Then look no further! As a Radiation Oncology Medical Director at eviCore, part of Evernorth Health Services, a division of The Cigna Group, you’ll use your clinical know-how to provide evidence-based medical reviews for patient care. Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases. This role offers you the opportunity to build new skills while enhancing the health and vitality of others. We’re seeking a detail-oriented individual with good communication, technology, and typing skills, as well as strong clinical judgment. Drive growth in your career with our innovative team.
• How you’ll make a difference:
• 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 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:
• M.D. or D.O. with a current, active, U.S. state medical license and board certified in Radiation Oncology, recognized by the American Board of Medical Specialties, or American Osteopathic Association
• Eligible to acquire additional state licensure as required
• 5 years of relevant clinical experience post residency/fellowship
• Knowledge of applicable state 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 time
• In accordance with our HITECH Security Accreditation, company provided encrypted-workstation is required to be hard-wire connected 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 internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an annual salary of 196,800 – 328,000 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also 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 on our employee benefits programs, visit Life at Cigna Group.
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. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, 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 applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
