Medical Director - Pathology

1w1 week ago

The Cigna Group

US · Full-time · $207,800 – $346,300

About this role

As a Medical Director at EviCore, you will apply your pathology expertise to deliver evidence-based medical reviews that support high-quality patient care. This intellectually stimulating role allows you to leverage your background in Anatomic Pathology, Clinical Pathology, or related subspecialties while staying current on healthcare regulations and industry developments.

You will complete time-sensitive, specialized evidence-based medical case reviews for medical necessity using EviCore’s case management software. The position includes conducting physician consultation calls with referring providers to discuss evidence-based medical necessity and appropriateness of requested services.

You will work collaboratively with over 500 EviCore physician colleagues to ensure patients receive proper care through evidence-based decision making. Training begins remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success.

This role offers the opportunity to build new skills while enhancing the health and vitality of others. Career growth opportunities exist across the enterprise with networking among peers across multiple medical specialties.

Requirements

M.D. or D.O. with a current, active U.S. medical license and board certification (ABMS or AOA) in Anatomic Pathology, Clinical Pathology, Cytopathology, Dermatopathology, Hematopathology, Molecular Genetic Pathology, or Neuropathology.
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 with ability to work autonomously with automated processes, computer applications, and systems.
Meet physical demands of the role including typing, speaking, and listening 100% of time.

Responsibilities

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.
Leverage clinical expertise to recommend alternative services or treatments as necessary.
Collaborate with over 500 EviCore physician colleagues to ensure patients receive proper care via evidence-based decision making.