Medical Director, Radiation Oncology Expert

Your Future Evolves Here Evolent is committed to transforming the healthcare landscape by collaborating with health plans and providers to enhance outcomes for individuals facing complex and costly health challenges. Our aim is to bridge the gaps in the healthcare system, ensuring that everyone receives the compassionate care they deserve. At Evolent, we prioritize work/life balance, flexibility, and empowerment, believing that our employees excel when they lead fulfilling lives. Diversity and inclusion are core values driving our culture. Join Evolent to make a difference. Stay for the inclusive environment. What You Will Be Doing: Serve as the primary physician reviewer for Radiation Oncology cases lacking initial medical necessity, as well as other imaging requests requiring specialized review. Engage in peer discussions with requesting physicians to provide clinical rationale for approvals and expedite appeals, all within the required regulatory timeframe. Utilize medical and clinical review guidelines to ensure compliance with organizational policies and standards (URAC, NCQA). Support the Initial Clinical Reviewers as a resource for queries and guidance. Document all communications with medical office staff and providers promptly and accurately. Collaborate with the Senior Medical Director on research initiatives and inquiries regarding the Utilization Management process. Participate in ongoing training sessions to guarantee consistency and reliability in reviews. Qualifications: MD/DO/MBBS degree is required. Five (5) years of post-residency medical practice experience, with recent clinical practice preferred. 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 health care programs, including Medicare or Medicaid. No significant disciplinary or legal actions reported by a state medical board. To maintain a secure hiring process, we have identity verification steps that require a government-issued photo ID. We also conduct comprehensive background checks and may require drug screening. The use of artificial intelligence during interviews is prohibited. Technical Requirements: All employees must have high-speed internet access of at least 10 Mbps and for call center roles, the ability to connect directly to their home internet router. These requirements are subject to change 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 require 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 necessary for the position. This may vary based on selected candidates. If you don’t see the perfect job for you listed, please send your resume and contact information our way, and we’ll reach out if we find the right fit!

Created: 2026-03-11