Field Medical Director, UM Physical Medicine

Field Medical Director, UM Physical Medicine at Evolent Health in Boise, Idaho, United States Job Description Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex 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. Evolent employees enjoy work / life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing : As a Field Medical Director- Physical Health, you will be a key member of the utilization management team. We can offer you a meaningful way to make a 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. We believe in embracing new ideas, challenging ourselves and failing forward. We have fun while working hard and often make a difference in everything from scrubs to jeans. Collaboration Opportunities : Evolent is looking for a Field Medical Director to be a member of the Evolent clinical team. As a collaborative member of a team of clinicians, physicians, pharmacists, health economists, and program coordinators, you will have the opportunity to make a profound impact on the lives of our members. Routinely interacts with leadership and management staff, other Physicians, and staff whenever a physician`s input is needed or required. As well as, aids and acts as a resource to Initial Clinical Reviewers. What you'll be doing : Supports pre-admission review, utilization management, and concurrent and retrospective review process. Participates in risk management, claim adjudication, pharmacy utilization management, catastrophic case review, outreach programs, Assists with execution of Evolent's benchmarked Utilization / Cost Management Program and relevant Clinical Quality Improvement Programs Participate in the Appeals and Grievance process, as necessary, to assure timely and accurate responses to members Supports design and implementation of health plan medical policies, and appropriate Care M To view full details and how to apply, please login or create a Job Seeker account