Director of Cardiology Medical Affairs

Your Future Evolves Here Evolent is dedicated to improving healthcare outcomes by partnering with health plans and providers to deliver exceptional care for individuals facing complex and costly health conditions. Our mission is to bridge the gaps within the fragmented healthcare system, ensuring that every patient receives the comprehensive care that we would want for our loved ones. As a member of Evolent, you’ll enjoy a balanced work-life environment with flexibility that suits your lifestyle, allowing you to excel and grow in your role. We believe that our employees thrive when supported to lead fulfilling lives and encouraged to express their authentic selves. This commitment to diversity and inclusion is a cornerstone of our organizational culture. Join Evolent for the mission. Stay for the culture. Your Key Responsibilities: Act as a specialty match reviewer for Cardiology cases that do not meet medical necessity criteria, conducting thorough reviews based on requests from providers, clients, or legal mandates. Provide clear clinical rationale for both standard and expedited appeals. Engage in discussions on determinations with requesting physicians or providers via peer-to-peer calls within specified regulatory timeframes. Utilize medical review guidelines to ensure consistency in the review process, aligning with Evolent's policies as well as URAC and NCQA standards. Accurately and promptly document all communications with medical offices or providers following interactions. Participate in continuous training exercises aimed at enhancing inter-rater reliability. Assist the Senior Medical Director in research and inquiries pertaining to Utilization Management processes and guidelines. As needed, serve as Medical Director for designated health plans or regions, overseeing accountability for utilization management in collaboration with the Senior Medical Director. Qualifications - Required and Preferred: MD/DO/MBBS Degree Current, unrestricted clinical license in your specialty Active Board Certification in Cardiology, Vascular Surgery, or Adult Congenital Heart Disease Strong competency in clinical practice, management, communication, and organization Proactive mindset with a keen interest in enhancing healthcare quality and value Proficient in computer applications At least five years of experience in Cardiology practice preferred No history of exclusion or sanctions by any state or federal healthcare program No major disciplinary actions from a state medical board For a secure hiring process, we have implemented various identity verification measures, including the requirement for a government-issued photo ID. Identity checks will be performed during the interview stages, and final interviews may require onsite attendance. All candidates will undergo rigorous background checks and may be subject to drug screening prior to employment. The expected compensation for this position ranges from $120 to $135 per hour, accompanied by a performance-based bonus component. Evolent offers a comprehensive benefits package, including health insurance, to eligible employees. All compensation decisions are based on the required skills and experience, which may vary among selected candidates. Evolent is proud to be an equal opportunity employer and considers all qualified applicants without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, veteran status, or disability status. If you need reasonable accommodation to access information on this website, please contact us for assistance. If you have not found your ideal job yet, submit your contact details and resume, and we will reach out if the perfect opportunity arises!

Created: 2026-03-10