Medical Director, Cardiology

Your Future Evolves Here

Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Evolenteers make a difference wherever they are, whether it is at a medical center, in the office, or while working from home across 48 states. We empower you to work from where you work best, which makes juggling careers, families, and social lives so much easier. Through our recognition programs, we also highlight employees who live our values, give back to our communities each year, and are champions for bringing their whole selves to work each day. If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission. Join a mission with a company behind it.

Why We’re Worth the Application:

• We continue to grow year over year.
• Recognized as a leader in driving important diversity, equity, and inclusion (DE&I) efforts.
• Achieved a 100% score two years in a row on the Human Rights Campaign's Corporate Equality Index recognizing us as a best place to work for LGBTQ+ equality.
• Named to Parity.org’s list of the best companies for women to advance for 3 years in a row (2020, 2021 and 2022).
• Continue to prioritize the employee experience and achieved a 90% overall engagement score on our employee survey in May 2022.
• Publish an annual DE&I report to share our progress on how we’re building an equitable workplace.

What You’ll Be Doing:

• As a Medical Director, Cardiology 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.
• Respect and maintain HIPAA confidentiality guidelines.
• Responsible for maintaining availability to clinical and non-clinical administrative staff during performance of initial and second level screening.
• Serve as subject matter expert and participate 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.
• Acts with honor and integrity, serving as a role model for the company.
• Performs other duties as assigned.

Qualifications - Required and Preferred:

• MD/DO/MBBS- Required
• Minimum of five (5) years’ experience in the practice of Cardiology- Required
• Current, unrestricted clinical license in medicine or required specialty- Required
• Obtaining and maintaining medical licenses in Required States- Required
• Active Board Certification in Cardiology-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