11 days old

Medical Director-Clinical Service Delivery

Cigna
Melbourne, FL 32901
  • Job Code
    21007822
Medical Director, Full-Time, eviCore Clinical Service Delivery team

The job profile for this position is Medical Director, which is a Band 5 Senior Contributor Career Track Role.

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We value our talented employees and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply!

Our people make all the difference in our success.

Clinical Service Delivery

The Clinical Service Delivery team (CSD) serves as clinical liaison to 40 health plans and interfaces with multiple eviCore departments on behalf of each health plan, its physicians, external providers and members. CSD maintains compliance with eviCore's policies and procedures and works closely with eviCore Complaints, Client Services, and legal/Compliance. CSD interacts daily with eviCore clinical subject matter experts in individual case reviews and complaint resolution, as well as in preparation for health plan and government audits.

Position Summary

The applicant must have excellent interpersonal skills and be able to work in a highly challenging, fast-paced environment. Superior writing skills are required. Sensitivity to HIPAA regulations and compliance regulations is required.

Analytical skills and familiarity with eviCore's operational structure are required The MD is expected to quickly analyze cases and requests, multi-task and work independently with multiple health plans and various escalated requests. The MD must exhibit thoughtful leadership skills and the ability to successfully work in concert with other members of CSD, both MDs and RNs.

Qualifications

Board-certified physician in an ABMS or AOA recognized specialty and with a current unrestricted medical license.

Exhibits ethical and professional behavior

Minimum of two year full-time employment with eviCore healthcare, currently at 40 hours/week.

Willingness to work both early morning and later afternoon hours, as assigned. Clinical Service Delivery is operational from 8:00am until 6:00pm, Monday through Friday.

Computer Competency: Microsoft office - Word, Powerpoint, Excel, as well as multiple eviCore casework platforms (ISAAC, Image One).

Ability to work within a changing business environment and balance patient advocacy with business needs.

Experience with managing multiple projects in a fast-paced environment

Demonstration of strong teamwork, conflict management, decision-making and problem-solving skills.

Ability to assess complex issues, to determine and implement their solutions and to resolve problems

Ability to maintain cooperative and successful relations with internal and external stakeholders

Experience in medical and case management is preferred.

Prior physician leadership positions is preferred.

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.

This position is not eligible to be performed in Colorado.

About Cigna

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. What difference will you make?

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 require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.





Posted: 2021-06-08 Expires: 2021-07-07
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Medical Director-Clinical Service Delivery

Cigna
Melbourne, FL 32901

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