Evolent Specialty Services is hiring a Field Medical Director, Interventional Cardiology to provide expert cardiovascular utilization management reviews remotely. You will conduct peer-to-peer discussions with treating providers to ensure high-value, evidence-based care aligned with clinical guidelines in a collaborative, non-clinical environment.
What You'll Do
- Provide expert reviews for cardiovascular cases as a specialty-matched expert reviewer for invasive and interventional cardiology procedures.
- Conduct peer-to-peer discussions with treating providers to ensure appropriate, high-value care.
- Collaborate with leadership, management, and clinical staff to address complex cases and support decision-making.
- Act as a key resource for Initial Clinical Reviewers, offering guidance and expertise on best practices.
- Provide clinical rationale for standard and expedited appeals.
- Discuss determinations via peer-to-peer phone calls with requesting physicians or ordering providers.
- Utilize medical and clinical review guidelines to assure consistency in the review process.
- Ensure timely and accurate documentation of all communications with medical office staff and providers.
- Participate in on-going training per the inter-rater reliability process.
- May assist the Senior Medical Director in research activities related to the Utilization Management process.
- On a requested basis, may function as Medical Director for select health plans or regions.
What We're Looking For
- MD/DO/MBBS degree.
- Current, unrestricted clinical license in medicine or required specialty.
- Ability to obtain and maintain medical licenses in your state of residence, as well as other states required per business needs.
- Active Board Certification in Interventional Cardiology or one of the following substitutes: Active Board Certification in Cardiology and proof of prior board certification in Interventional Cardiology; Active Board Certification in Cardiology and proof of active practice as an Interventional Cardiologist for 5+ years.
- Strong clinical, management, communication, and organizational skills.
- Energetic and curious with a passion for quality and value in health care.
- Computer proficiency.
- Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an 'excluded person'.
- No history of a major disciplinary or legal action by a state medical board.
Nice to Have
- Minimum of five (5) years’ experience in the practice of Cardiology.
Team & Environment
You will collaborate with a dynamic team of physicians, leaders, and clinical professionals. This role may assist the Senior Medical Director.
Benefits & Compensation
- A meaningful way to contribute to patient care beyond the clinical setting.
- Opportunities for collaboration with a dynamic team.
- A role that values innovation, continuous improvement, and clinical excellence.
- Comprehensive benefits, including health insurance.
- Compensation: $120-$135/hr.
Work Mode
This is a fully remote position open to candidates in any state.
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.
