Executive Medical Director, Radiology Clinical Strategy at Cigna in Bloomfield, Connecticut

Job Description:

The Executive Medical Director, Radiology Clinical Strategy supports strategic development product evolution of eviCore's Radiology management programs and services. Responsibilities include:

• Develop and oversee execution of clinical strategy for eviCore's Radiology Program, supporting the General Manager


• Serve as senior clinical representative to prospective eviCore Radiology program clients, and ensure adequate clinical support of prospective Radiology clients in collaboration with Clinical Service Delivery, Client Services, and Program business leadership


• Serve as senior clinical representative for eviCore's Radiology program to professional societies, provider organizations, and government affairs teams


• Collaborate with Radiology program leadership to develop and implement innovative management activities to improve clinical quality and drive affordability for Radiology clinical services


• Partner closely with Executive Medical Director, Radiology Clinical Performance to ensure ongoing alignment between Radiology strategy and operations, and provide backup senior clinical operations support to the General Manager when needed.


• Collaborate with leadership from Clinical Operations, Non-clinical Operations, and Program Operations to support and promote optimal program functioning and identify opportunities for innovation.


• Support the development and maintenance eviCore policies and procedures and criteria related to clinical certification.


• In collaboration with the Executive Medical Director, Radiology Clinical Operations, coordinate the clinical development and education of the Radiology program's Senior Medical Directors and Medical Directors through collection/circulation of educational materials, organization of quarterly educational sessions, and other activities as appropriate.


• Partner actively with subject matter experts from Radiology Clinical Performance and other relevant stakeholders to ensure the ongoing quality and currency of eviCore evidence-based Radiology clinical guidelines.


• Maintain current operational knowledge in performing timely expert medical review of medical necessity requests for clinical services, including post-decision reviews, within the Radiology program.


• Maintain necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications.


• Support and communicates eviCore policies and procedures to the provider community.


• Participate in all required educational and quality improvement activities and maintain passing scores in all assessment.


• Collaborate with appropriate guideline clinical leads and owners to obtain and maintain proficiency in guideline and denial rationale development and implementation.


• Collaborate with appropriate clinical subject matter experts to obtain and maintain proficiency in standard case processing, as well as peer-to-peer and other post-decision and escalated case reviews.


• Other duties as assigned.

• Minium Requirements-


• M.D. or D.O. degree from accredited institution.


• Minimum of five (5) years of clinical practice experience after completion of all graduate medical education training, including residency and fellowship (when applicable)


• Active board certification in medical or surgical specialty or subspecialty


• US as a utilization review doctor of medicine or doctor of osteopathic medicine.


• Knowledge of applicable state and federal laws, URAC and NCQA standards, and utilization management.


• Two (2) or more years of managed care experience.


• Supervisory and/or management experience strongly preferred.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an annual salary of 218,600 - 364,400 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus and long term incentive plan.

We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna .

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

Cigna has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.