eviCore healthcare Career Opportunities
Do you currently possess an active RN or LPN license that is in good standing?
How many years of clinical review experience do you possess?
Within the last 5 years, what role did the following play in your job:
CPT/ICD9 coding
Please note that this position is no longer available.
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Clinical Reviewer RN / LPN
Remote, Nationwide
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Make a Positive Impact on Patient Care While Working from Home

This is an outstanding opportunity to keep your clinical skills sharp and develop your utilization management talent as you review cases and procedures, ensuring that patients receive the most appropriate test or treatment for their condition. You'll work out of your home office, responding to calls and conducting initial medical reviews. Though you'll need to be licensed in the state where you reside, you'll enjoy speaking with people throughout the U.S. and managing a wide and diverse caseload. And, while you will work out of your home office, you won't work in a silo. We've created a culture and virtual environment where you won't be alone. You'll enjoy the support of a strong mentor and peers who are regularly available via face-to-face instant message! Along the way, you'll enjoy work/life balance that can be elusive in a hospital setting, strong training and the stability of a respected, rapidly growing company.  

eviCore healthcare is a medical benefit solutions company committed to making a positive impact in healthcare. It’s our passion, our purpose and our promise. Our mission is to help those we serve navigate the healthcare system, find the right care path and enable the best outcomes. In everything we do, we are guided by our core values of Integrity, Flexibility, Empathy and Collaboration. eviCore healthcare is growing rapidly and hiring to support that growth. We have multiple openings for Clinical Reviewers available, so feel free to share this information with your talented network of peers.

The Requirements

To meet the basic qualifications for this role you will have legal authorization to work permanently in the United States for any employer without requiring a visa transfer or visa sponsorship. In addition, to be a good fit for the Clinical Reviewer RN / LVN opportunity, you also should have:
  • Current, unrestricted RN or LPN licensure in the state of your primary residence  Quick question for you - click here
  • 2 to 3+ years of recent & pertinent clinical experience is highly desired, ideally acute care clinical experience (medical/surgical, ER, ICU)  Quick question for you - click here
  • The ability to pass a clinical assessment test
  • Computer literacy, including:
    • Comfort using the Internet for research
    • The ability to effectively shift between open windows and applications
    • The skill to use common software such as MS Office, especially Word
    • The ability to multitask, typing and moving between screens as you speak with callers, do research, complete paperwork, etc.
    • The skill to type 30+ wpm with excellent accuracy  
  • A quiet home office environment where you can talk on the phone and work undisturbed during specified hours
  • A commitment to providing outstanding customer service
  • The self-motivation and drive to excel and flourish in a virtual work environment
  • Inquisitiveness and the desire to continually learn
Preferred, but not required:
  • CPT/ICD9 coding knowledge Quick question for you - click here
  • Clinical call center experience
  • Past experience in a hospital setting
  • Experience working virtually
In addition, upon joining us you should be available to travel to TN, SC, FL, or CO for up to two weeks for training. You'll also need the flexibility to work an assigned shift between 7 a.m. and 8 p.m. Typically, you'll begin with a 9:30 a.m. to 6:00 p.m. shift, which may be modified once you are fully acclimated, based upon company needs and your preference.  

The Role

As Clinical Reviewer RN / LPN, you will work out of your home office and conduct initial medical reviews to determine the medical necessity of elective outpatient comprehensive imaging requests and other procedures. We currently support outpatient diagnostic and cardiac imaging, cardiac implantable devices, oncology drugs and therapeutic agents, radiation therapy, sleep, pain and lab services. As we continue to grow, we anticipate adding additional product lines.
 
Upon joining us you will undergo intensive training, then setup and begin working out of your home office. You will serve as a member of our extended clinical call center, sitting at your computer, wearing a headset and taking calls throughout the day. During the busy times you will take one call after another. You must be able to manage multiple tasks (Internet searches, typing, questioning, etc.) as you’re on the phone. These are not rote calls, but diverse cases that will require the breadth of your knowledge and assessment talents. You will work with multiple providers and offices and it will be up to you to ensure that patients receive the appropriate procedure the first time. Or, if guidelines are not met, that their cases are rerouted/escalated as appropriate. 

Specific responsibilities will include:
  • Processing preauthorization requests received by telephone, fax, or via the web
  • Performing review activities for procedures that require preauthorization 
  • Issuing approvals for studies that meet the specified guidelines
  • Forwarding studies that do not meet the guidelines to the Medical Director
  • Consistently providing optimum customer service
  • Documenting appropriate clinical information into the preauthorization system
  • Maintaining productivity, quality, telephonic and other service standards
  • Participating in on-going training programs to ensure quality performance and compliance with guidelines 
Note: this description is intended to give you a general overview of the position and is not an exhaustive listing of duties and responsibilities.

Why eviCore healthcare

Collaborative virtual environment – you'll enjoy many of the advantages of a virtual environment -- savings on clothes, gas and commute time, for example -- without some of the pitfalls. Though much of our team is virtual, they aren't isolated or alone. We're connected via instant message, and the team continually collaborates. In addition, you'll have a mentor you can reach out to when needed and we support ongoing professional development through WebEx and other mediums.   

Outstanding training – upon joining us you go through two weeks of onsite training with other new Clinical Reviewers. You'll have the opportunity to learn the eviCore healthcare way, interact with, learn from and build relationships with others at the same point in their eviCore healthcare journey, and work with experts in our company. Additionally, as already mentioned, you'll have the benefit of ongoing training.

High growth company – we're experiencing strong growth, both organic and through mergers and acquisitions. For example, recently the complementary talents, technologies and tactical acumen of CareCore and MedSolutions unified to become eviCore healthcare. For more information on our growth please see the About eviCore healthcare tab.That growth will continue moving forward. While you could be happy and satisfied in this role for years to come, if you want to advance your career, we anticipate advancement opportunities for our proven performers. From here you might step up to a mentorship or leadership role.

Critical mission – eviCore healthcare is committed to making sure that every patient receives exactly the health care they need. We know that every patient has a unique condition and medical history, so we manage tests and/or treatments to make sure they meet the latest standards of care to deliver the best possible outcomes. As a result we help to eliminate the cost and time wasted with inappropriate tests or treatments, while ensuring the highest levels of patient safety.You can feel pride knowing that your efforts will help both your patients and the ailing healthcare system.

Diversity – if you are an inquisitive person who likes to learn, you're going to love it at eviCore healthcare. You will investigate and work on a wide range of clinical conditions and learn what happens in treatment. That diversity keeps the position interesting because every day is different.  

A sense of pride – you can feel good knowing that your efforts will help deliver medical benefit solutions that benefit everyone: payers, providers and patients alike. Your efforts will impact lives day after day; your work will matter.

Excellent compensation – in addition to a competitive salary, eviCore healthcare offers a comprehensive benefits package including health insurance, dental coverage, a 401(k), paid vacations and holidays, life insurance coverage and the tools and equipment necessary to perform your role from your home office (telephone and computer).

Keys to Success

Naturally, your clinical talent will be essential to your success in this role, but to thrive it will take more than knowledge. You’ll need to be as dedicated at home as you would be in an office or hospital. Working at home doesn’t mean you have time to visit with a neighbor or run to the store. You will be on a regular 40-hour schedule, with two breaks and a half hour lunch each day. Outside of those breaks you will be expected to be at your desk and working and supporting the team, as they will also support you. 
 
Additionally, you will need to be skilled at the nuts and bolts of the work. Comfort balancing multiple tasks, and working effectively with the technology (hardware and software) will be critical. 
 

About eviCore healthcare

eviCore healthcare was founded in 1994 to provide comprehensive, customized programs to improve the use of diagnostic imaging and enhance the quality of care. eviCore healthcare’s innovative and quality-driven approach to radiology utilization management has made it the country’s fastest-growing outpatient diagnostic imaging utilization management services provider.

Building on our success, eviCore expanded its offering to include two highly specialized areas of care: cardiology and oncology. In 2005, eviCore launched eviCore Cardiology to manage cardiac care, including cardiac imaging and implantable devices. In 2007, eviCore launched eviCore Oncology to manage the use of oncology drugs and therapeutic agents. In 2008, eviCore added programs for sleep apnea, pain musculoskeletal management and lab services, which include high-cost genome testing.

eviCore healthcare ensures quality of healthcare by embracing the latest standards of care, deploying evidence-based models and managing treatment and diagnosis to achieve the best possible outcomes. We do this by using state-of-the-art technology and evidence-based criteria. All eviCore programs improve quality, streamline patient care and reduce cost. As our growing client list includes some of America’s most popular and trusted health plans, eviCore healthcare currently manages treatment affecting more than 30 million people.
 

Make a Positive Impact on Patient Care While Working from Home

This is an outstanding opportunity to keep your clinical skills sharp and develop your utilization management talent as you review cases and procedures, ensuring that patients receive the most appropriate test or treatment for their condition. You'll work out of your home office, responding to calls and conducting initial medical reviews. Though you'll need to be licensed in the state where you reside, you'll enjoy speaking with people throughout the U.S. and managing a wide and diverse caseload. And, while you will work out of your home office, you won't work in a silo. We've created a culture and virtual environment where you won't be alone. You'll enjoy the support of a strong mentor and peers who are regularly available via face-to-face instant message! Along the way, you'll enjoy work/life balance that can be elusive in a hospital setting, strong training and the stability of a respected, rapidly growing company.  

eviCore healthcare is a medical benefit solutions company committed to making a positive impact in healthcare. It’s our passion, our purpose and our promise. Our mission is to help those we serve navigate the healthcare system, find the right care path and enable the best outcomes. In everything we do, we are guided by our core values of Integrity, Flexibility, Empathy and Collaboration. eviCore healthcare is growing rapidly and hiring to support that growth. We have multiple openings for Clinical Reviewers available, so feel free to share this information with your talented network of peers.

The Requirements

To meet the basic qualifications for this role you will have legal authorization to work permanently in the United States for any employer without requiring a visa transfer or visa sponsorship. In addition, to be a good fit for the Clinical Reviewer RN / LVN opportunity, you also should have:
  • Current, unrestricted RN or LPN licensure in the state of your primary residence  Quick question for you - click here
  • 2 to 3+ years of recent & pertinent clinical experience is highly desired, ideally acute care clinical experience (medical/surgical, ER, ICU)  Quick question for you - click here
  • The ability to pass a clinical assessment test
  • Computer literacy, including:
    • Comfort using the Internet for research
    • The ability to effectively shift between open windows and applications
    • The skill to use common software such as MS Office, especially Word
    • The ability to multitask, typing and moving between screens as you speak with callers, do research, complete paperwork, etc.
    • The skill to type 30+ wpm with excellent accuracy  
  • A quiet home office environment where you can talk on the phone and work undisturbed during specified hours
  • A commitment to providing outstanding customer service
  • The self-motivation and drive to excel and flourish in a virtual work environment
  • Inquisitiveness and the desire to continually learn
Preferred, but not required:
  • CPT/ICD9 coding knowledge Quick question for you - click here
  • Clinical call center experience
  • Past experience in a hospital setting
  • Experience working virtually
In addition, upon joining us you should be available to travel to TN, SC, FL, or CO for up to two weeks for training. You'll also need the flexibility to work an assigned shift between 7 a.m. and 8 p.m. Typically, you'll begin with a 9:30 a.m. to 6:00 p.m. shift, which may be modified once you are fully acclimated, based upon company needs and your preference.  

The Role

As Clinical Reviewer RN / LPN, you will work out of your home office and conduct initial medical reviews to determine the medical necessity of elective outpatient comprehensive imaging requests and other procedures. We currently support outpatient diagnostic and cardiac imaging, cardiac implantable devices, oncology drugs and therapeutic agents, radiation therapy, sleep, pain and lab services. As we continue to grow, we anticipate adding additional product lines.
 
Upon joining us you will undergo intensive training, then setup and begin working out of your home office. You will serve as a member of our extended clinical call center, sitting at your computer, wearing a headset and taking calls throughout the day. During the busy times you will take one call after another. You must be able to manage multiple tasks (Internet searches, typing, questioning, etc.) as you’re on the phone. These are not rote calls, but diverse cases that will require the breadth of your knowledge and assessment talents. You will work with multiple providers and offices and it will be up to you to ensure that patients receive the appropriate procedure the first time. Or, if guidelines are not met, that their cases are rerouted/escalated as appropriate. 

Specific responsibilities will include:
  • Processing preauthorization requests received by telephone, fax, or via the web
  • Performing review activities for procedures that require preauthorization 
  • Issuing approvals for studies that meet the specified guidelines
  • Forwarding studies that do not meet the guidelines to the Medical Director
  • Consistently providing optimum customer service
  • Documenting appropriate clinical information into the preauthorization system
  • Maintaining productivity, quality, telephonic and other service standards
  • Participating in on-going training programs to ensure quality performance and compliance with guidelines 
Note: this description is intended to give you a general overview of the position and is not an exhaustive listing of duties and responsibilities.

Why eviCore healthcare

Collaborative virtual environment – you'll enjoy many of the advantages of a virtual environment -- savings on clothes, gas and commute time, for example -- without some of the pitfalls. Though much of our team is virtual, they aren't isolated or alone. We're connected via instant message, and the team continually collaborates. In addition, you'll have a mentor you can reach out to when needed and we support ongoing professional development through WebEx and other mediums.   

Outstanding training – upon joining us you go through two weeks of onsite training with other new Clinical Reviewers. You'll have the opportunity to learn the eviCore healthcare way, interact with, learn from and build relationships with others at the same point in their eviCore healthcare journey, and work with experts in our company. Additionally, as already mentioned, you'll have the benefit of ongoing training.

High growth company – we're experiencing strong growth, both organic and through mergers and acquisitions. For example, recently the complementary talents, technologies and tactical acumen of CareCore and MedSolutions unified to become eviCore healthcare. For more information on our growth please see the About eviCore healthcare tab.That growth will continue moving forward. While you could be happy and satisfied in this role for years to come, if you want to advance your career, we anticipate advancement opportunities for our proven performers. From here you might step up to a mentorship or leadership role.

Critical mission – eviCore healthcare is committed to making sure that every patient receives exactly the health care they need. We know that every patient has a unique condition and medical history, so we manage tests and/or treatments to make sure they meet the latest standards of care to deliver the best possible outcomes. As a result we help to eliminate the cost and time wasted with inappropriate tests or treatments, while ensuring the highest levels of patient safety.You can feel pride knowing that your efforts will help both your patients and the ailing healthcare system.

Diversity – if you are an inquisitive person who likes to learn, you're going to love it at eviCore healthcare. You will investigate and work on a wide range of clinical conditions and learn what happens in treatment. That diversity keeps the position interesting because every day is different.  

A sense of pride – you can feel good knowing that your efforts will help deliver medical benefit solutions that benefit everyone: payers, providers and patients alike. Your efforts will impact lives day after day; your work will matter.

Excellent compensation – in addition to a competitive salary, eviCore healthcare offers a comprehensive benefits package including health insurance, dental coverage, a 401(k), paid vacations and holidays, life insurance coverage and the tools and equipment necessary to perform your role from your home office (telephone and computer).

Keys to Success

Naturally, your clinical talent will be essential to your success in this role, but to thrive it will take more than knowledge. You’ll need to be as dedicated at home as you would be in an office or hospital. Working at home doesn’t mean you have time to visit with a neighbor or run to the store. You will be on a regular 40-hour schedule, with two breaks and a half hour lunch each day. Outside of those breaks you will be expected to be at your desk and working and supporting the team, as they will also support you. 
 
Additionally, you will need to be skilled at the nuts and bolts of the work. Comfort balancing multiple tasks, and working effectively with the technology (hardware and software) will be critical. 
 

About eviCore healthcare

eviCore healthcare was founded in 1994 to provide comprehensive, customized programs to improve the use of diagnostic imaging and enhance the quality of care. eviCore healthcare’s innovative and quality-driven approach to radiology utilization management has made it the country’s fastest-growing outpatient diagnostic imaging utilization management services provider.

Building on our success, eviCore expanded its offering to include two highly specialized areas of care: cardiology and oncology. In 2005, eviCore launched eviCore Cardiology to manage cardiac care, including cardiac imaging and implantable devices. In 2007, eviCore launched eviCore Oncology to manage the use of oncology drugs and therapeutic agents. In 2008, eviCore added programs for sleep apnea, pain musculoskeletal management and lab services, which include high-cost genome testing.

eviCore healthcare ensures quality of healthcare by embracing the latest standards of care, deploying evidence-based models and managing treatment and diagnosis to achieve the best possible outcomes. We do this by using state-of-the-art technology and evidence-based criteria. All eviCore programs improve quality, streamline patient care and reduce cost. As our growing client list includes some of America’s most popular and trusted health plans, eviCore healthcare currently manages treatment affecting more than 30 million people.
 
eviCore healthcare is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.
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