What are the responsibilities and job description for the Speech Therapist /Clinical Reviewer - eviCore - Work at Home position at 520 eviCore healthcare MSI, LLC?
Responsibilities:
Interact with providers on clinical issues and matters related to non-certification and other clinical issues as well as interaction with non-clinical staff and acts as an intermediary with the department Director. Responsible to perform prospective, retrospective and concurrent review consistent with eviCore clinical review protocols and URAC standards. Responsible to perform peer to peer consultations. Comprehension of the principles and procedures of utilization management of the AAHCC/URAC standards. Full knowledge and understanding of eviCore’s clinical guidelines/medical policies. Interpret clinical data as applicable. Participate in Grievance and Appeals Process. Other duties as necessary.
Minimum Experience:
Licensed Speech Therapist in state of employment
Minimum of ten (10) years of clinical experience
Experience with pediatric and adult patients preferred
Clinical review experience prefferred
Strong computer skills
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure. That’s why 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) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.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.
If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
