In this non-clinical utilization management role, the clinician reviews vascular surgery cases that do not initially meet medical necessity guidelines and provides specialty-level determinations for imaging and other requests. The work includes peer-to-peer discussions with ordering providers, appeal review, and support for consistent medical policy application. The role collaborates closely with physicians, leadership, and review staff and may also serve as a medical director for select plans or regions.

Key Responsibilities

Review vascular surgery cases that do not initially meet medical necessity guidelines.
Conduct specialty reviews for imaging and other requests when required by providers, clients, or state laws.
Discuss determinations with requesting physicians or ordering providers within required timeframes.
Provide clinical rationale for standard and expedited appeals.
Use medical review guidelines and parameters to support consistent utilization review decisions.
Support initial clinical reviewers with specialty input and clinical guidance.
Document all communications with medical office staff and physicians accurately and promptly.
Participate in ongoing training and inter-rater reliability processes.

Required

MD, DO, or MBBS degree.
Current, unrestricted clinical license in medicine or the required specialty.
Active board certification in Vascular Surgery, or active board certification in General Surgery with extensive vascular surgery experience.
Ability to obtain and maintain medical licenses in the state of residence.
Strong clinical, management, communication, organizational, and computer skills.

Preferred

At least 5 years of experience practicing vascular surgery.

Benefits & Perks

Work-from-home technical setup with high-speed internet required.
Comprehensive benefits, including health insurance benefits, for qualifying employees.
Expected base salary of $130-$140/hr.
Work/life balance and scheduling flexibility.
Autonomy in a non-clinical environment.
Opportunities for collaboration and continuous learning.

Key Responsibilities

Review vascular surgery cases that do not initially meet medical necessity guidelines.
Conduct specialty reviews for imaging and other requests when required by providers, clients, or state laws.
Discuss determinations with requesting physicians or ordering providers within required timeframes.
Provide clinical rationale for standard and expedited appeals.
Use medical review guidelines and parameters to support consistent utilization review decisions.
Support initial clinical reviewers with specialty input and clinical guidance.
Document all communications with medical office staff and physicians accurately and promptly.
Participate in ongoing training and inter-rater reliability processes.

Required

MD, DO, or MBBS degree.
Current, unrestricted clinical license in medicine or the required specialty.
Active board certification in Vascular Surgery, or active board certification in General Surgery with extensive vascular surgery experience.
Ability to obtain and maintain medical licenses in the state of residence.
Strong clinical, management, communication, organizational, and computer skills.

Preferred

At least 5 years of experience practicing vascular surgery.

Benefits & Perks

Work-from-home technical setup with high-speed internet required.
Comprehensive benefits, including health insurance benefits, for qualifying employees.
Expected base salary of $130-$140/hr.
Work/life balance and scheduling flexibility.
Autonomy in a non-clinical environment.
Opportunities for collaboration and continuous learning.

Field Medical Director, Vascular Surgeon

$130 - $140 / hour

Key Responsibilities

Required

Preferred

Benefits & Perks

Field Medical Director, Vascular Surgeon

$130 - $140 / hour

Key Responsibilities

Required

Preferred

Benefits & Perks