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Clinical Reviewer, Nurse Practitioner/Physician Assistant (Vascular Surgery)
Evolent is seeking a clinical reviewer nurse practitioner or physician assistant specializing in vascular surgery to support administrative and clinical utilization management. This remote role involves peer clinical reviews, provider communication, and quality improvement functions.
Job Description
Role Overview
Evolent partners with health plans and providers to achieve better outcomes for complex health conditions. We are seeking a Nurse Practitioner or Physician Assistant to support cardiology and vascular surgery administrative and clinical utilization management.
Essential Duties
- Act as a clinical liaison to providers, clients, and patients
- Conduct clinical conversations with providers regarding medical necessity decisions
- Maintain and operate Guideline Directed Medical Therapy
- Communicate needs for additional clinical information to ordering providers
- Prepare cases for peer-to-peer discussions with Vascular Surgeons or Cardiologists
- Coordinate with UM staff for timely communication of clinical decisions
- Complete UM projects and participate in site visit reviews
- Maintain HIPAA confidentiality and interdepartmental liaison duties
Technical Requirements
- High-speed internet over 10 Mbps
- Ability to plug in directly to the home internet router
Requirements & Skills
Specialty
Vascular Surgery
Education
Master
Experience
5+ years
Licenses
Skills