Job Description

Medical Director - Pediatric Otolaryngology- EviCore (Finance)

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 Pediatric Otolaryngology 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:

• Start training remotely in a structured environment with support from trainers, mentors, and leadership.
• Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity using eviCore's case management software.
• Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence-based medical necessity and appropriateness of requested services or treatments.
• Leverage your clinical expertise to recommend alternative services or treatments as necessary.
• Work collaboratively with over 500 eviCore physician colleagues to 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 certification in Pediatric Otolaryngology recognized by the American Board of Medical Specialties or the American Osteopathic Association
• Preferred: one of the following state medical licenses: DC, MD, or VA
• Eligible to acquire additional state licensure as required
• 5 years of relevant clinical experience post-residency/fellowship
• Knowledge of applicable state and federal laws
• Utilization Review Accreditation Commission and National Committee for Quality Assurance standards are a plus
• Ability to commit to a set, weekly work schedule (Monday through Friday)
• Strong computer skills: ability to work autonomously with automated processes, applications, and systems
• Meet physical demands including typing, speaking, and listening 100% of the time
• Company-provided encrypted workstation required to be hard-wired to a modem or router; wireless connection not permitted

If working from home, internet must be via cable broadband or fiber optic with at least 10Mbps download and 5Mbps upload speeds.

Anticipated annual salary ranges from $203,200 to $338,600, depending on experience and location, with eligibility for an annual bonus plan.

We offer comprehensive benefits from day one, including medical, vision, dental, behavioral health, 401(k) with match, life insurance, tuition reimbursement, at least 18 days of paid time off, and paid holidays. For details, visit Life at Cigna Group.

About Evernorth Health Services:

Evernorth creates pharmacy, care, and benefit solutions to improve health and vitality, relentlessly innovating to make prediction, prevention, and treatment more accessible. Join us in driving growth and improving lives.

Qualified applicants will be considered regardless of race, color, age, disability, sex, pregnancy, sexual orientation, gender identity, veteran status, religion, national origin, marital status, genetic information, or other protected characteristics.

For reasonable accommodation in the application process, contact SeeYourself@cigna.com. Do not email for application updates or resumes.

The Cigna Group maintains a tobacco-free policy and may not hire tobacco/nicotine users in states where permissible, unless enrolled in a cessation program prior to employment. States include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington.

Applicants with criminal histories will be considered per applicable laws.

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