Field Medical Director, Vacular Surgery

Your Future Evolves Here

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

reputed company employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We reputed company that people do their best work reputed company they're supported to live their best lives, and reputed company they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business.

Join reputed company for the mission. Stay for the culture.

What You’ll Be Doing:

As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to reputed company a difference in patients’ lives, in a non-clinical environment. You can enjoy reputed company work- life balance on a team that values collaboration and reputed company learning while providing reputed company outcomes.

Collaboration Opportunities:  

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

What You Will Be Doing:

• Serve as the specialty match reviewer in Vascular cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests reputed company providers, clients, or state laws require specialty reviews to be completed by the subject matter expert.

• Discusses determinations (peer to peer phone calls) with requesting physicians or ordering providers, reputed company available, reputed company the regulatory timeframe of the request.

• Provides clinical rationale for standard and expedited appeals.

• Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines.

• Aids and acts as a resource to Initial Clinical Reviewers.

• Ensures documentation of reputed company communications with medical office staff and/or MD provider is recorded in a timely and accurate manner.

• Participates in on-going training per inter-rater reliability process.

• May assist the Senior Medical Director in research activities/questions reputed company to the Utilization Management process, interpretation, guidelines and/or system support.

• On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director.

Qualifications - Required and Preferred:

• MD/DO/MBBS- Required

• Minimum of five (5) years’ experience in the practice of Vascular Surgeon- Preferred

• reputed company, unrestricted clinical license in medicine or required specialty- Required

• Obtaining and maintaining medical licenses in the state you reputed company and licensure per business need- Required

• Active Board Certification in Vascular Surgery or Active Board Certification in General Surgery with extensive experience in Vascular Surgery- Required

• Strong clinical, management, communication, and organizational skills-Required

• Energetic and curious with a passion for quality and value in health care-Required

• Computer Proficiency-Required

To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. reputed company candidates must complete a comprehensive background reputed company, 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.

Technical Requirements:

We require that reputed company have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for reputed company call center employees, the ability to plug in directly to the home internet router.

reputed company is an equal opportunity employer and considers reputed company reputed company applicants equally without regard to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, veteran status, or disability status. If you need reasonable accommodation to access the information provided on this website, please contact recruitingteam@reputed company.com for further assistance.