Job Description

Medical Director - Post-Acute Care - Evicore - Remote

Join to apply for the Medical Director - Post-Acute Care - Evicore - Remote role at Evernorth Health Services .

Summary: The Medical Director provides timely expert medical review of medical necessity requests for clinical services that do not meet utilization review criteria and renders a clinical opinion about the medical service under review while located in a state or territory of the United States.

Responsibilities include:

• Review medical necessity requests for post-acute care and provide clinical opinions, including post-decision reviews.
• Engage in peer-to-peer discussions with treating physicians to clarify clinical information and review outcomes.
• Participate in discharge planning and case conferences with nursing and social work teams.
• Document review actions and maintain credentials, reporting any adverse license or certification actions.
• Support clinical guideline reviews, communicate policies, testify at appeals, and serve as a clinical resource.
• Participate in educational activities, quality improvement, and respond to provider or member complaints.
• Support scheduled weekend calls and participate in virtual meetings and committees.

Minimum Education, Licensure, and Certification:

• M.D. or D.O. degree from an accredited institution.
• At least three years of post-graduate clinical practice experience.
• Active board certification in Family Medicine, Internal Medicine, or Emergency Medicine.
• Unrestricted medical license in a U.S. state or territory.
• Knowledge of relevant laws, standards, and utilization management.
• Ability to work a set weekly schedule and possess strong computer skills.

This position offers an annual salary range of $203,200 - $338,600, with potential for bonuses. Benefits include health coverage, 401(k) match, paid time off, and more. The role is remote, requiring reliable high-speed internet and adherence to security protocols.

About Evernorth Health Services: A division of The Cigna Group, creating innovative health solutions to improve care accessibility and outcomes.

Qualified applicants will be considered regardless of race, color, age, disability, sex, or other protected characteristics. Reasonable accommodations are available upon request.

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