EviCore healthcare, part of Evernorth Health Services and The Cigna Group, is hiring a Medical Director - Physical Medicine and Rehabilitation. In this role, you will apply your clinical expertise to conduct evidence-based medical reviews for patient care, focusing on durable medical equipment (DME) and related services. You'll be a key part of ensuring patients receive proper care through collaborative, evidence-based decision making.
What You'll Do
- Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity using EviCore’s case management software.
- Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence-based medical necessity and treatment appropriateness.
- Leverage clinical expertise to recommend alternative services or treatments as necessary.
- Serve as a subject matter expert for medical necessity requests for durable medical equipment (DME), Home Health (HH), and other specialty-matched cases.
- Testify at ALJ Hearings when your cases are appealed.
- Document all actions related to clinical review sessions and attest to review qualifications as required.
- Work collaboratively with over 500 EviCore physician colleagues.
What We're Looking For
- M.D. or D.O. with a current, active, U.S. state medical license.
- Board certified in Physical Medicine & Rehabilitation recognized by the American Board of Medical Specialties or American Osteopathic Association.
- Eligible to acquire additional state licensure as required.
- 3 years of relevant clinical experience post residency/fellowship.
- Knowledge of applicable state and federal laws.
- Ability to commit to a set, weekly work schedule (Monday through Friday) and provide intermittent weekend call coverage.
- Strong computer skills to work autonomously with automated processes and systems.
- Ability to meet physical demands including typing, speaking, and listening.
- Ability to use a company-provided encrypted workstation hard-wired to a modem/router (wireless not permitted).
- Internet connection via cable broadband or fiber optic provider with speeds of at least 10Mbps download/5Mbps upload.
Nice to Have
- Familiarity with Utilization Review Accreditation Commission and National Committee for Quality Assurance standards.
Technical Stack
- EviCore’s case management software
Team & Environment
You will collaborate with over 500 EviCore physician colleagues across multiple medical specialties.
Benefits & Compensation
- Compensation range: $203,200 - $338,600 USD / yearly
- Benefits start on day one
- Predictable work schedules
- 100% work from home
- 8 Paid Holidays + 23 PTO Days (minimum 18 days paid time off per year)
- 401(K) with company match
- Reimbursement for continuing medical education and tuition
- Career growth opportunities across the enterprise
- Networking with peers across multiple medical specialties
- Comprehensive health, vision, dental, well-being, and behavioral health programs
- Company paid life insurance
Work Mode
This is a global, 100% remote position.
EviCore healthcare is a part of The Cigna Group, driving growth and improving lives by relentlessly innovating to make the prediction, prevention, and treatment of illness and disease more accessible. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
