Your Future Evolves Here

Evolent partners with health plans and providers to achieve better outcomes for people with the most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of the fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.

Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy to get things done. We believe that people do their best work when they are supported to live their best lives and feel welcome to bring their whole selves to work. Diversity and inclusion are core to our business.

As a FMD, you will be a key member of the utilization management team. You can make a meaningful difference in patients' lives in a non-clinical environment. You can enjoy better work-life balance on a team that values collaboration and continuous learning while providing better health outcomes.

• Routinely interacts with leadership and management staff, other Physicians, and staff when a physician's input is needed or required.

• Serve as the Physician match reviewer in Radiation Oncology for cases that do not initially meet applicable medical necessity guidelines, and for other imaging requests when specialty reviews are required by providers, clients, or state law.
• Discuss determinations with requesting physicians or ordering providers via peer-to-peer communications within regulatory timeframes and provide clinical rationale for standard and expedited appeals.
• Utilize medical/clinical review guidelines to ensure consistency in the MD review process and alignment with URAC and NCQA guidelines and company policies/procedures.
• Aid and act as a resource to Initial Clinical Reviewers.
• Document all communications with medical office staff and/or MDs in a timely and accurate manner.
• May assist the Senior Medical Director in research activities related to Utilization Management, interpretation, guidelines, or system support.
• Participate in ongoing training per inter-rater reliability processes.

• MD/DO/MBBS
• Minimum of five (5) years of medical practice experience post-residency; active clinical practice within the last 2 years preferred
• Current, unrestricted clinical license in medicine or required specialty
• Obtaining and maintaining medical licenses in the state of residence and any licenses required by business needs
• Active Board Certification in Radiation Oncology
• Strong clinical, management, communication, and organizational skills
• Energetic and curious with a passion for quality and value in health care
• Computer proficiency
• No current exclusion or sanction by any state or federal health care program (including Medicare/Medicaid); not identified as an excluded person by the OIG or GSA; no major disciplinary actions by a state medical board

To ensure a secure hiring process, identity verification steps include submission of a government-issued photo ID. Identity verification may occur during interviews and final interviews may require onsite attendance. All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration.

All employees must have at-home technical capability: high-speed Internet over 10 Mbps and for call center employees, the ability to plug in directly to the home Internet router. Requirements are subject to change with any scheduled re-opening of office locations.

Evolent is an equal opportunity employer and considers all qualified applicants 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 (see below) for further assistance.

The expected base salary/rate for this position is $130-140/hr. This position is eligible for a bonus component based on pre-defined performance factors. Our total compensation package includes comprehensive benefits (including health insurance) for qualifying employees. All compensation determinations are based on the skills and experience required for the position and may vary above or below the stated amounts.

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