eviCore healthcare Career Opportunities


Please note that this position is no longer available.
If you would like to be considered for similar opportunities now or in the future, feel free to apply and/or set up a notifier for yourself.
Clinical Nurse Reviewer
CO - Colorado Springs
or
Apply with

Make a Positive Impact on Patient Care in a Monday - Friday operation in Colorado Springs, CO

$4500 sign on bonus offered for this position.







Come see our core teams in action through our Day in the Life video








If you’re a skilled RN or LPN with recent clinical care experience, this “best-of-both-worlds” position could be your ideal opportunity. You’ll use your skills to support patients, ensuring they receive appropriate care, while enjoying work/life balance that includes a set schedule with no weekend hours.

Working Monday through Friday in our office in Colorado Springs, CO, you will be responsible for taking clinical certification calls/faxes from physician office and imaging center staff members requesting authorization for clinical services for their patients. You will be tasked with reviewing requests, comparing them against established clinical protocols and authorizing services as needed and appropriate. This is a prime opportunity with a respected and rapidly growing company -- a chance to keep your clinical skills sharp and add to your knowledge base by working on a diverse range of calls. We will set you up for success via strong training, including on the case management software you'll use, and provide ongoing support as you take ownership of your role. At the end of the day, you can feel pride in knowing you did great work, but you can also turn off your computer and fully give your attention to other interests without the worries that often accompany hands-on clinical patient care. Prove yourself and you will find there are also ample opportunities for advancement with eviCore healthcare. 

We have multiple Clinical Reviewer positions available in Colorado Springs, so feel free to share this information with your network of talented and qualified peers. To be considered, you must be able to work any 8-hour shift between 7 a.m. and 9 p.m. Specific shifts will be assigned and can be modified after a specified amount of time based upon performance and availability. Additionally, after six months of service in-house, you may have the option of working remotely from your home office.  

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.

The Requirements

To meet the basic requirement for this role, you must be legally authorized to work permanently in the U.S. for any employer without requiring a Visa transfer or Visa sponsorship. 

To be a strong fit for the role of Clinical Reviewer, you will need:
  • Current, unrestricted RN or LPN licensure in Colorado  
  • 2+ years of recent & pertinent clinical experience  
  • 1 year hands-on critical care, medsurg, ER, urgent care or specialty care experience is ideal  
  • Computer literacy, including:
    • Comfort using the Internet for research
    • Strong understanding of basic computer operations (e.g. moving between open windows and applications; using two monitors; performing copy and paste tasks; dragging windows, using a mouse, etc.) 
    • The skill to use common software such as MS Office, especially Word
    • The ability to multitask, including typing and moving between screens as you speak with callers
    • The skill and ability to type 30+ wpm with excellent accuracy while talking on the phone
Helpful, but not required, skills and knowledge:
  • CPT/ICD9 coding knowledge 
  • Experience with computer data entry, customer service, medical terminology, and/or managed care 
In addition to required skills and knowledge, the ideal candidate will be self-directed and highly-motivated to excel in a virtual environment with strict schedule requirements. In addition, success in the role will require:
  • A commitment to providing outstanding customer service
  • Accurate and effective verbal and written communication skills
  • The ability to:
    • Relate well to all types of people
    • Listen actively and responsively
    • Multi-task in a fast-paced environment
    • Handle confidential information
  • Excellent critical thinking skills
  • A strong detail orientation
In addition, before hire you will need to pass a typing test, and computer literacy assessment.
 

The Role

Onboarding
Upon joining us, you will participate in an intensive five week training course where you’ll learn about eviCore, the expectations of your role, the case management software, procedures and policies and much more. Training will take place between 8:00 a.m. and 5:00 p.m. daily. You must be available to attend every day of training. After your training is complete, you will be assigned a Monday through Friday shift between 7:00 a.m. and 9:00 p.m., dependent upon the needs of the business. You will benefit from working in the Colorado Springs office for the first six months, after which you may have the opportunity to work from your home office. 

Day in the Life
As Clinical Reviewer, you will serve as a member of our in-house or extended clinical call center (when moving to a home office). You will sit at a computer throughout your shift, wearing a headset and taking calls. Often you will take one call after another, and you will always be required to handle multiple tasks during calls -- typing, questioning, switching between screens, etc. 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.

Typically, you’ll take between 50 and 60 calls per day (approximately 45 if you’re focused on oncology). Perhaps half of the requests will cover modalities that you’ll become expert in in short order. Others will be more unusual, will take longer and require the depth of your skill. Most often you’ll be speaking to a non-clinical person, so you will learn guidelines which will help you uncover the necessary information. 

Specific responsibilities will include:
  • Processing pre-authorization requests primarily received by telephone or via fax or the web
  • Performing review activities for procedures that require pre-authorization and
    • Issuing approvals for studies that meet the specified guidelines OR
    • Forwarding studies that do not meet the guidelines to the medical director
  • Providing optimum customer service
  • Documenting appropriate clinical information into the pre-authorization system
  • Maintaining productivity, quality, telephonic, and other service standards
  • Participating in on-going training programs to ensure quality performance and compliance with guidelines
  • Adhering to all eviCore protocols, policies and procedures
  • Performing other duties as assigned
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 environment in house and virtually
We have a supportive and collaborative environment you'll enjoy many of the advantages of a virtual environment that will help you learn and excel in your role as you're working in the office. That sense of team will continue as you move into a home office setting. 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 five 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. 

Career growth
While this role could keep you satisfied well into the future, if you want to grow your career, you will find ample opportunities for advancement. You could step up to a team lead then manager role, take on a training assignment and teach newer Clinical Reviewers, serve as an auditor, listening in on calls or follow a different path in the organization. Growth equals opportunity and we believe in hiring from within whenever possible.

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. 

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 and bonus opportunity, 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 will need the desire to learn and grow professionally, as well as a willingness to be mentored to improve your skills. You will build effective relationships with other team members, and own your responsibilities, demonstrating a strong work ethic and providing outstanding service. When you move to a home-based role, you’ll need to be just as dedicated at home as you were in the office. Working at home doesn’t mean you have time to visit with a neighbor or run to the store. We've already said it, but it is so important that it's worth mentioning again here: you will be expected to work your regular 40-hour schedule, with two breaks and a half hour lunch each day. Outside of those breaks you must be at your desk, 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 will be critical as you work to meet key performance metrics.
 

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 in a Monday - Friday operation in Colorado Springs, CO

$4500 sign on bonus offered for this position.







Come see our core teams in action through our Day in the Life video








If you’re a skilled RN or LPN with recent clinical care experience, this “best-of-both-worlds” position could be your ideal opportunity. You’ll use your skills to support patients, ensuring they receive appropriate care, while enjoying work/life balance that includes a set schedule with no weekend hours.

Working Monday through Friday in our office in Colorado Springs, CO, you will be responsible for taking clinical certification calls/faxes from physician office and imaging center staff members requesting authorization for clinical services for their patients. You will be tasked with reviewing requests, comparing them against established clinical protocols and authorizing services as needed and appropriate. This is a prime opportunity with a respected and rapidly growing company -- a chance to keep your clinical skills sharp and add to your knowledge base by working on a diverse range of calls. We will set you up for success via strong training, including on the case management software you'll use, and provide ongoing support as you take ownership of your role. At the end of the day, you can feel pride in knowing you did great work, but you can also turn off your computer and fully give your attention to other interests without the worries that often accompany hands-on clinical patient care. Prove yourself and you will find there are also ample opportunities for advancement with eviCore healthcare. 

We have multiple Clinical Reviewer positions available in Colorado Springs, so feel free to share this information with your network of talented and qualified peers. To be considered, you must be able to work any 8-hour shift between 7 a.m. and 9 p.m. Specific shifts will be assigned and can be modified after a specified amount of time based upon performance and availability. Additionally, after six months of service in-house, you may have the option of working remotely from your home office.  

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.

The Requirements

To meet the basic requirement for this role, you must be legally authorized to work permanently in the U.S. for any employer without requiring a Visa transfer or Visa sponsorship. 

To be a strong fit for the role of Clinical Reviewer, you will need:
  • Current, unrestricted RN or LPN licensure in Colorado  
  • 2+ years of recent & pertinent clinical experience  
  • 1 year hands-on critical care, medsurg, ER, urgent care or specialty care experience is ideal  
  • Computer literacy, including:
    • Comfort using the Internet for research
    • Strong understanding of basic computer operations (e.g. moving between open windows and applications; using two monitors; performing copy and paste tasks; dragging windows, using a mouse, etc.) 
    • The skill to use common software such as MS Office, especially Word
    • The ability to multitask, including typing and moving between screens as you speak with callers
    • The skill and ability to type 30+ wpm with excellent accuracy while talking on the phone
Helpful, but not required, skills and knowledge:
  • CPT/ICD9 coding knowledge 
  • Experience with computer data entry, customer service, medical terminology, and/or managed care 
In addition to required skills and knowledge, the ideal candidate will be self-directed and highly-motivated to excel in a virtual environment with strict schedule requirements. In addition, success in the role will require:
  • A commitment to providing outstanding customer service
  • Accurate and effective verbal and written communication skills
  • The ability to:
    • Relate well to all types of people
    • Listen actively and responsively
    • Multi-task in a fast-paced environment
    • Handle confidential information
  • Excellent critical thinking skills
  • A strong detail orientation
In addition, before hire you will need to pass a typing test, and computer literacy assessment.
 

The Role

Onboarding
Upon joining us, you will participate in an intensive five week training course where you’ll learn about eviCore, the expectations of your role, the case management software, procedures and policies and much more. Training will take place between 8:00 a.m. and 5:00 p.m. daily. You must be available to attend every day of training. After your training is complete, you will be assigned a Monday through Friday shift between 7:00 a.m. and 9:00 p.m., dependent upon the needs of the business. You will benefit from working in the Colorado Springs office for the first six months, after which you may have the opportunity to work from your home office. 

Day in the Life
As Clinical Reviewer, you will serve as a member of our in-house or extended clinical call center (when moving to a home office). You will sit at a computer throughout your shift, wearing a headset and taking calls. Often you will take one call after another, and you will always be required to handle multiple tasks during calls -- typing, questioning, switching between screens, etc. 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.

Typically, you’ll take between 50 and 60 calls per day (approximately 45 if you’re focused on oncology). Perhaps half of the requests will cover modalities that you’ll become expert in in short order. Others will be more unusual, will take longer and require the depth of your skill. Most often you’ll be speaking to a non-clinical person, so you will learn guidelines which will help you uncover the necessary information. 

Specific responsibilities will include:
  • Processing pre-authorization requests primarily received by telephone or via fax or the web
  • Performing review activities for procedures that require pre-authorization and
    • Issuing approvals for studies that meet the specified guidelines OR
    • Forwarding studies that do not meet the guidelines to the medical director
  • Providing optimum customer service
  • Documenting appropriate clinical information into the pre-authorization system
  • Maintaining productivity, quality, telephonic, and other service standards
  • Participating in on-going training programs to ensure quality performance and compliance with guidelines
  • Adhering to all eviCore protocols, policies and procedures
  • Performing other duties as assigned
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 environment in house and virtually
We have a supportive and collaborative environment you'll enjoy many of the advantages of a virtual environment that will help you learn and excel in your role as you're working in the office. That sense of team will continue as you move into a home office setting. 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 five 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. 

Career growth
While this role could keep you satisfied well into the future, if you want to grow your career, you will find ample opportunities for advancement. You could step up to a team lead then manager role, take on a training assignment and teach newer Clinical Reviewers, serve as an auditor, listening in on calls or follow a different path in the organization. Growth equals opportunity and we believe in hiring from within whenever possible.

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. 

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 and bonus opportunity, 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 will need the desire to learn and grow professionally, as well as a willingness to be mentored to improve your skills. You will build effective relationships with other team members, and own your responsibilities, demonstrating a strong work ethic and providing outstanding service. When you move to a home-based role, you’ll need to be just as dedicated at home as you were in the office. Working at home doesn’t mean you have time to visit with a neighbor or run to the store. We've already said it, but it is so important that it's worth mentioning again here: you will be expected to work your regular 40-hour schedule, with two breaks and a half hour lunch each day. Outside of those breaks you must be at your desk, 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 will be critical as you work to meet key performance metrics.
 

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.

If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact the Human Resources Department at amitchellkhan@engage2excel.com.
or
Apply with