How you'll make a difference:- You'll start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success.
- 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 or treatment.
- Leverage your clinical expertise to recommend alternative services or treatments as necessary.
- Work collaboratively with over 500 EviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making.
What you'll enjoy about working here:- Benefits start on day one
- Predictable work schedules
- 100% work from home
- 8 Paid Holidays + 23 PTO Days
- 401(K) with company match
- Reimbursement for continuing medical education
- Career growth opportunities across the enterprise
- Networking with 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 Pediatric Pulmonology
- 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: ability to work autonomously with automated processes, computer applications, and systems
- Meet physical demands of the role including, but not limited to, typing, speaking, and listening 100% of time
- In accordance with our HITECH Security Accreditation, company provided encrypted-workstation is required to be hard-wire connected to a modem or router. Wireless connection is not permitted.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an annual salary of 207,800 - 346,300 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.
