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.

M.D. or D.O. with a current, active U.S. medical license and board certification (ABMS or AOA) in Gastroenterology.
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 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.

Medical Director – Gastroenterology

Key skills