Field Medical Director, Vascular Surgeon

Job Summary

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

Collaboration Opportunities

• Routinely interacts with leadership and management staff, other physicians, and staff whenever physician input is needed or required.

Responsibilities

• Serve as the specialty match reviewer for 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.
• Discuss determinations (peer‐to‐peer phone calls) with requesting physicians or ordering providers, when available, within the regulatory timeframe of the request.
• Provide clinical rationale for standard and expedited appeals.
• Utilize medical/clinical review guidelines and parameters to assure consistency in the MD review process, reflecting appropriate utilization and compliance with SBU’s policies/procedures, as well as URAC and NCQA guidelines.
• Aid and act as a resource to Initial Clinical Reviewers.
• Ensure documentation of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner.
• Participate in ongoing training per inter‐rater reliability process.
• May assist the Senior Medical Director in research activities or 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

• MD/DO/MBBS – Required
• Minimum of five (5) years’ experience in the practice of vascular surgery – 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

Technical Requirements

All employees must have high‐speed internet at home of at least 10 Mbps. Employees in call‐center roles must be able to plug directly into the home internet router.

Equal Opportunity Statement

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 recruitingteam@evolent.com for further assistance.

Compensation

The expected base salary/wage range for this position is $130‐140 per hour. As part of our total compensation package, Evolent offers comprehensive benefits, including health insurance benefits, to qualifying employees.