Physician Clinical Reviewer, Radiation Oncology

Your Future Evolves HereEvolent 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 PCR, Radiation Oncology 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.Collaboration Opportunities:

Routinely interacts with leadership and management staff, other Medical Directors, and health plan members and staff whenever a physician`s input is needed or required. Responsible for acting as a clinical liaison to providers, clients, and patients as directed by the office of the Chief Medical Officer.

What You Will Be Doing:

Responsible for implementation and maintenance of all clinical program guidelines.

Responsible for participation in the Utilization Management (UM) Committee.

Responsible for performing peer reviews including peer-to-peer conversations.

Responsible for communicating need for additional clinical information to ordering providers.

Responsible for coordinating with UM staff to ensure timely and accurate communication of clinical decisions with a respectful demeanor and maintaining HIPAA confidentiality guidelines.

Responsible for maintaining availability to clinical and non-clinical administrative staff during performance of initial and second level screening, while serving as a subject matter expert in meetings, as assigned with practices and/or payers.

Perform all peer clinical review activities while located in a state or territory of the United States.

Qualifications - Required and Preferred:

Graduate of recognized medical degree program- Required

Minimum of five (5) years’ experience in the practice of Radiation oncology- Required

At least two years of experience in a regulatory role- Preferred

Current, unrestricted clinical license in medicine or required specialty- Required

Obtaining and maintaining medical licenses in Required States- Required

Active Board Certification in Radiation Oncology - 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

Technical Requirements:We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.Evolent is an equal opportunity employer and considers all qualified applicants equally 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 recruiting@evolent.com for further assistance.The expected base salary/wage range for this position is $110-$135/hr. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts.Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!For more insights about Evolent Health, click on Life At Evolent (https://www.evolent.com/) to learn more!