Medical Director – Maternal-Fetal Medicine (OB/GYN) – Evicore - Remote
Core
Deliver evidence-based medical reviews and conduct peer-to-peer physician consultations to determine medical necessity for Maternal-Fetal Medicine cases.
Role type
Senior clinical reviewer (Maternal-Fetal Medicine)
Builds
Evidence-based medical decisions for patient care
Domain
Healthcare / Utilization Review
Required skills
Clinical judgment, Evidence-based decision making, Physician consultation, Regulatory knowledge, Case review, Treatment recommendation
Preferred skills
Knowledge of Utilization Review Accreditation Commission standards, Knowledge of National Committee for Quality Assurance standards
Technologies
Case management software
Responsibilities
Review medical cases for evidence-based medical necessity, Conduct peer-to-peer calls with referring providers, Recommend alternative services or treatments, Collaborate with physician colleagues
Seniority
Senior, hands-on IC