Field Medical Director, Interventional Cardiology (Remote)

Your Future Evolves HereEvolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business.Join Evolent for the mission. Stay for the culture.What You’ll Be Doing:Job DescriptionCardiovascular Utilization Management Reviewer (Interventional Cardiologist)Are you ready to make a meaningful impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the delivery of high-value, evidence-based case reviews. Enjoy improved work-life balance while contributing to better health outcomes in an environment that fosters collaboration, continuous learning, and impactful peer-to-peer discussions. What We Offer:A meaningful way to contribute to patient care beyond the clinical setting.Opportunities for collaboration with a dynamic team of physicians, leaders, and clinical professionals.A role that values innovation, continuous improvement, and clinical excellence.This position is 100% Remote and can be completed from any state. Multiple opportunities for a flexible schedule and both part-time and full-time options available. What You’ll Do:Provide expert reviews for cardiovascular cases, serving as a specialty-matched expert reviewer for invasive/interventional cardiology cases (e.g., cardiac catheterizations, coronary interventions, endovascular procedures, implantable cardiac devices, etc) that do not initially meet medical necessity guidelines or require further evaluation by a subject matter expert. Conduct peer-to-peer discussions with treating providers to ensure appropriate, high-value care aligned with clinical guidelines. Collaborate with leadership, management, and clinical staff to address complex cases and support decision-making. Act as a key resource for Initial Clinical Reviewers, offering guidance and expertise to ensure the application of best practices. Provides clinical rationale for standard and expedited appeals.Discusses determinations (peer to peer phone calls) with requesting physicians or ordering providers, when available, within the regulatory timeframe of the request.Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s pol...