Director of Medical Affairs in Pain Management

Join Us in Making a Difference At Evolent, we are dedicated to transforming healthcare by collaborating with health plans and providers to improve outcomes for individuals facing complex and costly health conditions. Our mission spans various specialties and primary care, closing gaps in the fragmented healthcare system to ensure compassionate care for everyone. Become a part of Evolent's meaningful mission, where we value work-life balance and diversity. We believe our employees thrive when they bring their authentic selves to work, fostering a collaborative environment for growth. What You Will Contribute: As the Director of Medical Affairs with a focus on Pain Management, you will be a key figure in shaping our utilization management team. This is a remarkable opportunity to make a positive impact on patient lives within a supportive, non-clinical work environment that prioritizes collaboration and continuous learning. Your Collaboration Responsibilities: Engage with leadership, management, and fellow Physicians to provide valuable insights. Support Initial Clinical Reviewers as a key resource. Your Key Responsibilities Include: Act as the Physician Clinical Reviewer for Interventional Pain Management, assessing cases that do not meet medical necessity guidelines and addressing specialty requests as needed. Facilitate peer-to-peer discussions with requesting physicians about determinations within the required regulatory timeframe. Implement clinical review guidelines to ensure consistency and adherence to organizational policies, including URAC and NCQA standards. Offer clinical rationale for standard and expedited appeals, maintaining comprehensive documentation of all communications. Participate in ongoing training to bolster the inter-rater reliability process. When necessary, serve as Medical Director for specific health plans or regions, in collaboration with the Senior Medical Director on utilization management initiatives. Required and Preferred Qualifications: MD/DO/MBBS - Required Minimum of five (5) years' experience in Pain Medicine, post-residency - Preferred Unrestricted clinical license in medicine or relevant specialty - Required The ability to maintain medical licenses in your state and any other necessary states - Required Active Board Certification in Pain Management or equivalent, combined with clinical experience in Interventional Pain Management - Required Strong clinical, management, communication, and organizational skills - Required Energetic and inquisitive nature with a commitment to delivering quality healthcare - Required Proficiency in computer skills - Required To ensure a secure hiring process, we have established strict identity verification steps, including the submission of a government-issued photo ID during interviews. Final interviews may require in-person attendance. A comprehensive background check and drug screening may be necessary prior to employment. The use of artificial intelligence tools during interviews is strictly prohibited. Technical Requirements: All employees are required to have high-speed internet access above 10 Mbps. Call center employees must connect directly to a home internet router. These requirements may change based on the reopening of our physical office locations. Evolent is proud to be an equal opportunity employer. We consider all applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status. If you require reasonable accommodation to access information on this website, please contact us for assistance. The expected base salary for this role is $105-110 per hour, with an additional performance-based bonus component. Evolent provides a comprehensive benefits package, including health insurance coverage, to qualifying employees. Compensation for this position will be determined based on the necessary skills and experience required, which may vary among selected individuals. If you don't see your dream job here, submit your contact information and resume to be considered for future opportunities!

Created: 2026-03-04