As a Medical Director at EviCore, part of Evernorth Health Services, a division of The Cigna Group, you'll use your clinical know-how to provide evidence-based medical reviews for patient care.
As a Medical Director at EviCore, part of Evernorth Health Services, a division of The Cigna Group, you'll use your clinical know-how to provide evidence-based medical reviews for patient care.
PRIOR AUTHORIZATION SPECIALIST
Kew Gardens, NY · On-site
$22 - $26/hr
... Evicore, AIM, Healthcare Partners websites, as well as directly from insurance companies via phone, - ability to communicate professionally and efficiently on the phone and in person. Health benefits ...
Quick apply
PRIOR AUTHORIZATION SPECIALIST
Kew Gardens, NY · On-site
$22 - $26/hr
... Evicore, AIM, Healthcare Partners websites, as well as directly from insurance companies via phone, - ability to communicate professionally and efficiently on the phone and in person. Health benefits ...
PRIOR AUTHORIZATION SPECIALIST
Kew Gardens, NY · On-site
$22 - $26/hr
... Evicore, AIM, Healthcare Partners websites, as well as directly from insurance companies via phone, - ability to communicate professionally and efficiently on the phone and in person. Health benefits ...
Quick apply
PRIOR AUTHORIZATION SPECIALIST
Kew Gardens, NY · On-site
$22 - $26/hr
... Evicore, AIM, Healthcare Partners websites, as well as directly from insurance companies via phone, - ability to communicate professionally and efficiently on the phone and in person. Health benefits ...
Medical Reception
Manahawkin, NJ · On-site
$16/hr
The ideal candidate is compassionate, patient, and knowledgeable about healthcare practices ... Obtain prior authorizations via Evicore * Obtain health insurance benefits Qualifications
Quick apply
Medical Reception
Manahawkin, NJ · On-site
$16/hr
The ideal candidate is compassionate, patient, and knowledgeable about healthcare practices ... Obtain prior authorizations via Evicore * Obtain health insurance benefits Qualifications
... EviCore's Durable Medical Equipment and Home Health management programs and services ... Two (2) or more years of managed care experience * Supervisory and/or management experience ...
... EviCore's Durable Medical Equipment and Home Health management programs and services ... Two (2) or more years of managed care experience * Supervisory and/or management experience ...
Medical Reception
Manahawkin, NJ · On-site
$16/hr
The ideal candidate is compassionate, patient, and knowledgeable about healthcare practices ... Obtain prior authorizations via Evicore * Obtain health insurance benefits Qualifications
Quick apply
Medical Reception
Manahawkin, NJ · On-site
$16/hr
The ideal candidate is compassionate, patient, and knowledgeable about healthcare practices ... Obtain prior authorizations via Evicore * Obtain health insurance benefits Qualifications
As a Medical Director at EviCore, part of Evernorth Health Services, a division of The Cigna Group, you'll use your clinical know-how to provide evidence-based medical reviews for patient care.
As a Medical Director at EviCore, part of Evernorth Health Services, a division of The Cigna Group, you'll use your clinical know-how to provide evidence-based medical reviews for patient care.
PRIOR AUTHORIZATION SPECIALIST
Kew Gardens, NY · On-site
$22 - $26/hr
... Evicore, AIM, Healthcare Partners websites, as well as directly from insurance companies via phone, - ability to communicate professionally and efficiently on the phone and in person. Health benefits ...
Quick apply
PRIOR AUTHORIZATION SPECIALIST
Kew Gardens, NY · On-site
$22 - $26/hr
... Evicore, AIM, Healthcare Partners websites, as well as directly from insurance companies via phone, - ability to communicate professionally and efficiently on the phone and in person. Health benefits ...
Medical Reception
Manahawkin, NJ · On-site
$16/hr
The ideal candidate is compassionate, patient, and knowledgeable about healthcare practices ... Obtain prior authorizations via Evicore * Obtain health insurance benefits Qualifications
Quick apply
Medical Reception
Manahawkin, NJ · On-site
$16/hr
The ideal candidate is compassionate, patient, and knowledgeable about healthcare practices ... Obtain prior authorizations via Evicore * Obtain health insurance benefits Qualifications
As a Medical Director at EviCore, part of Evernorth Health Services, a division of The Cigna Group, you'll use your clinical know-how to provide evidence-based medical reviews for patient care.
As a Medical Director at EviCore, part of Evernorth Health Services, a division of The Cigna Group, you'll use your clinical know-how to provide evidence-based medical reviews for patient care.
Provide expert guidance on healthcare data exchange, interoperability standards, and system integrations. * Research, analyze, and resolve technical issues to minimize client disruption and improve ...
Provide expert guidance on healthcare data exchange, interoperability standards, and system integrations. * Research, analyze, and resolve technical issues to minimize client disruption and improve ...
Provide expert guidance on healthcare data exchange, interoperability standards, and system integrations. * Research, analyze, and resolve technical issues to minimize client disruption and improve ...
Provide expert guidance on healthcare data exchange, interoperability standards, and system integrations. * Research, analyze, and resolve technical issues to minimize client disruption and improve ...
Onco EMR, Concur Expense Management, MModal, DoxyMe, Evicore, and virtual meeting platforms Why ... healthcare environment dedicated to providing outstanding patient care. You will play a crucial ...
Onco EMR, Concur Expense Management, MModal, DoxyMe, Evicore, and virtual meeting platforms Why ... healthcare environment dedicated to providing outstanding patient care. You will play a crucial ...
Experience in home health, skilled nursing facility, rehabilitation, post-acute care, or care coordination. * Experience with Medicare and/or Medicaid managed care programs. Work Environment * This ...
Experience in home health, skilled nursing facility, rehabilitation, post-acute care, or care coordination. * Experience with Medicare and/or Medicaid managed care programs. Work Environment * This ...
Director, Technical Product Management - Applied AI
Morris Plains, NJ · On-site
$238K - $249K/yr
Finance or healthcare industry experience. * Experience supporting product adoption, operating model changes, or enterprise-scale transformation. * Master's degree in Computer Science, Information ...
New
Director, Technical Product Management - Applied AI
Morris Plains, NJ · On-site
$238K - $249K/yr
Finance or healthcare industry experience. * Experience supporting product adoption, operating model changes, or enterprise-scale transformation. * Master's degree in Computer Science, Information ...
New
Onco EMR, Concur Expense Management, MModal, DoxyMe, Evicore, and virtual meeting platforms Why ... healthcare environment dedicated to providing outstanding patient care. You will play a crucial ...
Onco EMR, Concur Expense Management, MModal, DoxyMe, Evicore, and virtual meeting platforms Why ... healthcare environment dedicated to providing outstanding patient care. You will play a crucial ...
Registration Specialist- Jersey Shore
Somers Point, NJ · On-site
$16.75 - $22.25/hr
... platforms, including eviCore, TurningPoint, Availity, PEAR, and other applicable systems ... High school diploma or GED required; healthcare patient experience preferred * Strong ...
Registration Specialist- Jersey Shore
Somers Point, NJ · On-site
$16.75 - $22.25/hr
... platforms, including eviCore, TurningPoint, Availity, PEAR, and other applicable systems ... High school diploma or GED required; healthcare patient experience preferred * Strong ...
Senior Pharmacy Technician Advocate
Saint Charles, MO · On-site
$23.14/hr
Recognized as one of the Best 150+ Places to Work in Healthcare and a Military-Friendly Gold ... Evicore) and maintaining oversight of expiration timelines to prevent lapses in care. * Clinical ...
Senior Pharmacy Technician Advocate
Saint Charles, MO · On-site
$23.14/hr
Recognized as one of the Best 150+ Places to Work in Healthcare and a Military-Friendly Gold ... Evicore) and maintaining oversight of expiration timelines to prevent lapses in care. * Clinical ...
Onco EMR, Concur Expense Management, MModal, DoxyMe, Evicore, and virtual meeting platforms Why ... healthcare environment dedicated to providing outstanding patient care. You will play a crucial ...
Onco EMR, Concur Expense Management, MModal, DoxyMe, Evicore, and virtual meeting platforms Why ... healthcare environment dedicated to providing outstanding patient care. You will play a crucial ...
Senior Pharmacy Technician Advocate
Saint Charles, MO · On-site +1
$23.14 - $32.26/hr
... Evicore) and maintaining oversight of expiration timelines to prevent lapses in care. * Clinical ... Minimum 2 years of experience in healthcare revenue cycle, patient access, pharmacy billing, or ...
Senior Pharmacy Technician Advocate
Saint Charles, MO · On-site +1
$23.14 - $32.26/hr
... Evicore) and maintaining oversight of expiration timelines to prevent lapses in care. * Clinical ... Minimum 2 years of experience in healthcare revenue cycle, patient access, pharmacy billing, or ...
Evicore Healthcare information
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What is Evicore Healthcare?
What are the key skills and qualifications needed to thrive at Evicore Healthcare?
What are some common challenges faced by professionals working at Evicore Healthcare, and how can applicants prepare for them?
What is the difference between Evicore Healthcare vs Medical Coder?
| Aspect | Evicore Healthcare | Medical Coder |
|---|---|---|
| Certifications | Varies, often includes coding certifications like CPC | Typically requires CPC or equivalent |
| Work Environment | Healthcare administration, insurance processing | Medical offices, hospitals, billing companies |
| Industry Usage | Utilized by healthcare providers and insurance companies | Used across healthcare facilities for billing and coding |
Evicore Healthcare primarily focuses on healthcare management and insurance processing, while Medical Coders specialize in translating medical records into billing codes. Both roles require coding certifications and work within healthcare settings, but their core functions differ—Evicore handles claims and authorizations, whereas Medical Coders focus on accurate coding for billing purposes.
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Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Re-posted 25 days ago
Cigna Healthcare rating
8.3
Based on 241 frontline employees who took The Breakroom Quiz
40th of 898 rated healthcare providers
Job description
Job Description
Do you crave an intellectually stimulating job that allows you to leverage your clinical expertise while developing new skills and improving the lives of others? Then look no further! As a Medical Director at EviCore, part of Evernorth Health Services, a division of The Cigna Group, you'll use your clinical know-how to provide evidence-based medical reviews for patient care. Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases. This role offers you the opportunity to build new skills while enhancing the health and vitality of others. We're seeking a detail-oriented individual with good communication, technology, and typing skills, as well as strong clinical judgment. Drive growth in your career with our innovative team.
How you'll make a difference:
You'll start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success.
Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on EviCore's case management software.
Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence-based medical necessity and appropriateness of the requested service or treatment.
Leverage your clinical expertise to recommend alternative services or treatments as necessary.
Work collaboratively with over 500 EviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making.
What you'll enjoy about working here:
Benefits start on day one
Predictable work schedules
100% work from home
8 Paid Holidays + 23 PTO Days
401(K) with company match
Reimbursement for continuing medical education
Career growth opportunities across the enterprise
Networking with peers across multiple medical specialties
Requirements:
M.D. or D.O. with a current, active, U.S. state medical license and board certified in PM&R, Family Medicine, Emergency Medicine and Internal Medicine, recognized by the American Board of Medical Specialties, or American Osteopathic Association
Eligible to acquire additional state licensure as required
3 years of relevant clinical experience post residency/fellowship
Knowledge of applicable state federal laws
Utilization Review Accreditation Commission and National Committee for Quality Assurance standards is a plus
Ability to commit to a set, weekly work schedule (Monday through Friday)
Strong computer skills: ability to work autonomously with automated processes, computer applications, and systems
Meet physical demands of the role including, but not limited to, typing, speaking, and listening 100% of time
In accordance with our HITECH Security Accreditation, company provided encrypted-workstation is required to be hard-wire connected to a modem or router. Wireless connection is not permitted.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an annual salary of 207,800 - 346,300 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
At The Cigna Group, 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), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.
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 need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.
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.
What Cigna Healthcare employees say
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About Cigna
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Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Bloomfield, CT, US