eviCore

Career Opportunities

Below are our most current career opportunities. Click on the job title for more information.  

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Job Locations US-TN-Franklin
The Registered Nurse will perform clinical and operational processes related to transition / coordination of care/case management of Post-Acute Care services including but not limited to Home Health, DME, Care Coordination/Care management.. The Registered Nurse is responsible for ensuring the member is receiving all services or equipment as ordered by the physician.  May assist with the coordination between providers and members.
Career ID
2020-7826
Career Category
Clinical
Job Locations US-TN-Franklin
The Clinical Supervisor is responsible for day-to-day operations of Care Coordination activities of the Care coordination team. Focuses on policy and strategy implementation for short-term results (1 year or less). Works collaboratively with the Hospital Case Management, PAC providers (HH/DME),eviCore leadership and Care Coordinators, acting as a liaison to ensure process compliance and appropriate discharge planning and/or case management from the acute care setting and post-acute setting where applicable. Provides primary input to hiring, firing, promotion, performance and rewards decisions for direct reports.  
Career ID
2020-7825
Career Category
Clinical
Job Locations US-TN-Franklin
The Manager will work collaboratively with the Hospitals, Physicians, Providers, members, eviCore leadership and eviCore Care Coordinators, acting as a leader, to ensure process compliance and appropriate discharge planning from the acute care setting.The Manager will work collaboratively with the Hospitals, Physicians, Providers, members, eviCore leadership and eviCore Care Coordinators, acting as a leader, to ensure process compliance and appropriate discharge planning from the acute care setting.  
Career ID
2020-7824
Career Category
Clinical
Job Locations US-TN-Franklin
The PAC Case Administrator is responsible for maintaining workflow activities for the HH/DME/HIT Network for inbound and outbound communications between eviCore Healthcare stakeholders and external hospitals, physicians and Post-Acute Care providers. The Care Coordination Case Administrator demonstrates complete understanding of how to research and resolve issues pertaining to the pre-certification of services as well as delivery of services and day-to-day operational concerns using defined processes. Demonstrates full understanding and ability to differentiate the Care Coordination processes across multiple states to ensure compliance with both Medicare and Medicaid guidelines by state regulations and commercial plans. They are responsible for communicating all state specific and national health care laws to external hospitals, physicians and Post-Acute Care providers including the appeals/reconsideration policies.  Inbound and outbound communications tasks include coordination of inbound requests from hospitals, physicians and Post-Acute Care providers for pre and re-certification, status checks on existing cases, directing calls to internal departments, notification calls to hospitals and Post-Acute Care providers regarding incomplete pre-certification requests, as well as authorization approvals. In addition, this position is responsible for outbound calls to members, providers, physicians and hospitals to ensure member is receiving ordered/approved services. The Care Coordination Case Administrator is responsible for evaluating client trends to report and partner with the appropriate internal stakeholders in order to address and resolve through facilitation of communication between clients, providers, IT and other eviCore healthcare team members.  
Career ID
2020-7823
Career Category
Contact Center
Job Locations US-TN-Franklin
The Supervisor, PAC Case Administrators will supervise the team of Care coordination agents for the Care Coordination team within eviCore. They will serve as a primary point of contact for program and processes for the Care Coordination team. The Case Administrator is responsible for - Maintain workflow activities for the care coordination product for inbound and outbound communications between eviCore Healthcare stakeholders, Health plan and external hospitals, physicians, Post-Acute Care providers and members. - Participate in the development and implementation of technical and operational processes and   workflows for internal care coordination operations in order to meet or exceed the standards set by CMS, Accreditation bodies, Client service-level agreements, and applicable state regulatory requirements in which eviCore conducts business. - Manage specific team functions and processes, including but not limited to: management of the inbound/outbound telephonic teams, management of PAC Cherwell box, and special client and provider projects as assigned. - Identify opportunities for quality and process improvement and engages necessary matrix partners to design and implement solutions, effectively handles and resolves priority issues, and works collaboratively with other eviCore operational leaders to oversee end-to-end process development and adherence.   
Career ID
2020-7821
Career Category
Clinical
Job Locations US-Remote
Thinking about joining eviCore as an Associate Medical Director?   Working at eviCore allows you to make a difference in people’s lives by improving the quality of their healthcare. As an Associate Medical Director, you will feel intellectually stimulated and challenged, and you will be empowered by the difference you are making on a more global level in healthcare. Additional advantages of working at eviCore as an Associate Medical Director include: - Predictable work schedules: No nights, no weekends, no call - 100% Remote with full and part-time opportunities - Salaried position with benefits - The ability to impact healthcare on a larger scale  - Supportive organization with collaborative culture: Hands-on training provided in our Melbourne, FL office Responsibilities:    Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. - Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. - Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. - Documents all actions related to clinical review sessions and attests to appeal review qualifications as required. - Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. - Participates in strategic planning for and evaluation of the Care Management process/unit.
Career ID
2020-7719
Career Category
Clinical
Job Locations US-Remote
Thinking about joining eviCore as an Associate Medical Director?   Working at eviCore allows you to make a difference in people’s lives by improving the quality of their healthcare. As an Associate Medical Director, you will feel intellectually stimulated and challenged, and you will be empowered by the difference you are making on a more global level in healthcare. Additional advantages of working at eviCore as an Associate Medical Director include: - Predictable work schedules: No nights, no weekends, no call - 100% Remote with full and part-time opportunities - Salaried position with benefits - The ability to impact healthcare on a larger scale  - Supportive organization with collaborative culture: Hands-on training provided in our Melbourne, FL office Responsibilities:    Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. - Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. - Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. - Documents all actions related to clinical review sessions and attests to appeal review qualifications as required. - Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. - Participates in strategic planning for and evaluation of the Care Management process/unit.
Career ID
2020-7684
Career Category
Clinical
Job Locations US-Remote
  Thinking about joining eviCore as an Associate Medical Director?   Working at eviCore allows you to make a difference in people’s lives by improving the quality of their healthcare. As an Associate Medical Director, you will feel intellectually stimulated and challenged, and you will be empowered by the difference you are making on a more global level in healthcare. Additional advantages of working at eviCore as an Associate Medical Director include: - Predictable work schedules: No nights, no weekends, no call - 100% Remote with full and part-time opportunities - Salaried position with benefits - The ability to impact healthcare on a larger scale  - Supportive organization with collaborative culture: Hands-on training provided in our Melbourne, FL office Responsibilities:    Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. - Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. - Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. - Documents all actions related to clinical review sessions and attests to appeal review qualifications as required. - Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. - Participates in strategic planning for and evaluation of the Care Management process/unit.
Career ID
2020-7587
Career Category
Clinical
Job Locations US-Remote
Thinking about joining eviCore as an Associate Medical Director?   Working at eviCore allows you to make a difference in people’s lives by improving the quality of their healthcare. As an Associate Medical Director, you will feel intellectually stimulated and challenged, and you will be empowered by the difference you are making on a more global level in healthcare. Additional advantages of working at eviCore as an Associate Medical Director include: - Predictable work schedules: No nights, no weekends, no call - 100% Remote with full and part-time opportunities - Salaried position with benefits - The ability to impact healthcare on a larger scale  - Supportive organization with collaborative culture: Hands-on training provided in our Melbourne, FL office Responsibilities: - Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. - Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. - Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. - Documents all actions related to clinical review sessions and attests to appeal review qualifications as required. - Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. - Participates in strategic planning for and evaluation of the Care Management process/unit.  
Career ID
2020-7518
Career Category
Clinical
Job Locations US-Remote
Thinking about joining eviCore as an Associate Medical Director?   Working at eviCore allows you to make a difference in people’s lives by improving the quality of their healthcare. As an Associate Medical Director, you will feel intellectually stimulated and challenged, and you will be empowered by the difference you are making on a more global level in healthcare. Additional advantages of working at eviCore as an Associate Medical Director include: - Predictable work schedules: No nights, no weekends, no call - 100% Remote with full and part-time opportunities - Salaried position with benefits - The ability to impact healthcare on a larger scale  - Supportive organization with collaborative culture: Hands-on training provided in our Melbourne, FL office Responsibilities:    Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. - Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. - Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. - Documents all actions related to clinical review sessions and attests to appeal review qualifications as required. - Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. - Participates in strategic planning for and evaluation of the Care Management process/unit.
Career ID
2020-7496
Career Category
Clinical

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