Expert Medical Director in Radiation Oncology

Your Future Starts Here Evolent is leading the charge in healthcare transformation, partnering with health plans and providers to improve outcomes for individuals facing complex and often costly health challenges. Our mission is to fill the gaps within the healthcare system, ensuring everyone receives the compassionate care they need and deserve. At Evolent, we highly value work/life balance, flexibility, and empowerment, as we believe our employees thrive when they lead fulfilling lives. Our culture is built on the principles of diversity and inclusion. Join Evolent to make a meaningful difference. Stay for the welcoming environment. Key Responsibilities: Act as the primary physician reviewer for Radiation Oncology cases that lack initial medical necessity, along with other imaging requests needing specialized review. Engage in peer discussions with requesting physicians to articulate clinical justifications for approvals and expedite the appeals process, all while adhering to required regulatory timelines. Employ medical and clinical review guidelines to guarantee compliance with organizational policies and standards (URAC, NCQA). Provide support to Initial Clinical Reviewers, addressing their queries and offering guidance. Document all interactions with medical office staff and providers promptly and accurately. Collaborate with the Senior Medical Director on research initiatives and inquiries related to Utilization Management processes. Participate in ongoing training sessions to ensure consistency and reliability in reviews. Qualifications: MD/DO/MBBS degree is required. A minimum of five (5) years of post-residency medical practice experience, with recent clinical practice preferred. A valid, unrestricted medical license in your specialty is essential. Active Board Certification in Radiation Oncology is required. Exceptional clinical, communication, and organizational skills are crucial. A passion for delivering quality healthcare services is key. Proficiency in computer skills is necessary. No exclusions or sanctions by any healthcare programs, including Medicare or Medicaid. No significant disciplinary or legal actions reported by a state medical board. To ensure a secure hiring process, we have implemented identity verification steps requiring a government-issued photo ID. We also conduct comprehensive background checks and may require drug testing. Please note that the use of artificial intelligence during interviews is strictly prohibited. Technical Requirements: All employees are required to have high-speed internet access of at least 10 Mbps. For roles involving call center duties, direct connection to a home internet router is mandatory. These requirements may evolve based on future operational needs. Evolent is an equal opportunity employer, welcoming all qualified candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status. If you need accommodations, please contact us for assistance. The expected base hourly rate for this role is $130-140/hr, with performance-based bonuses available. Evolent offers a comprehensive benefits package to eligible employees, with compensation tailored to the skills and experience required for the position. This may vary based on the selected candidates. If you don't see your ideal job listed, please send us your resume and contact information, and we will reach out if we find an appropriate fit!

Created: 2026-03-04