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The Senior Medical Director works directly with the Chief of Laboratory Management Services and other program stakeholders to develop and implement all aspects of eviCore’s Laboratory Management program. This may include the management of both molecular and non-molecular tests.
- Monitor trends in laboratory testing, technology advancement, disease management, and outcomes assessment that may identify new molecular and non-molecular testing areas to target for management
- Contribute to the development and maintenance of laboratory clinical guidelines and management strategies
- Assist with development of savings analyses to measure program effect
- Collaborate with program leadership in establishing annual goals for the Lab Program
- Support Lab program business development efforts by participating in prospective client sales presentations
- Participate actively in all Lab program clinical case review activities, including but not limited to, initial written reviews for pre-service and post-service medical necessity determinations, telephonic peer consultations, and appeal decisions
- Provide operational leadership to other physician reviewers in the Lab program, supporting the Chief of Laboratory Services
- Assist the Chief of Laboratory Services in providing oversight for program quality management activities, including but not limited to the development and monitoring of clinical quality measures, subject matter training of clinical review staff, and case review audits for physician reviewers in the Lab program
- Participation in recruiting appropriate clinical and program support staff members
- Serve as a liaison to active health plan client medical directors to ensure the smooth and optimal functioning of the program
- Discuss emerging evidence and eviCore Lab program clinical guidelines with treating physicians, laboratories and health plan medical directors in support of the Chief of Laboratory Services
- Complete other duties as assigned by the Chief of Laboratory Services or eviCore’s Chief Medical Officer
- Board certification in Anatomic or Clinical Pathology is preferred, but board certification in other clinical specialties recognized by the American Board of Medical Specialties (ABMS) may be considered if all other requirements are met
- Active unrestricted license to practice medicine in a state or territory of the United States as a doctor of medicine (MD) or doctor of osteopathic medicine (DO), with knowledge of applicable state and federal laws
- Five or more years of experience in a managing/leading a clinical laboratory that performed non-molecular testing
- Experience with molecular and genomic tests, in addition to non-molecular testing, is required.
- Knowledge of applicable state and federal laws governing the operation of a clinical laboratory is required
- Knowledge of pertinent medical management accreditation requirements such as URAC and NCQA is a plus
Five or more years of experience in a managing/leading a clinical laboratory that performed non-molecular testing. Experience with molecular and genomic tests, in addition to non-molecular testing, is required. Knowledge of pertinent medical management accreditation requirements. Excellent communication and presentation skills.