Medical Director, Post Acute Care- PM&R

The Cigna Group

Job Overview

Location

United States Work at Home

Job Type

Full-time

Full Job Description

📋 Description

• Perform evidence-based medical case reviews for medical necessity using EviCore’s case management software, focusing on post-acute care and PM&R-related services.
• Conduct peer-to-peer physician consultation calls with referring providers to discuss the appropriateness and medical necessity of requested treatments or services.
• Recommend alternative services or treatments based on clinical expertise and evidence-based guidelines to optimize patient care outcomes.
• Work within a structured remote training environment with ongoing support from trainers, mentors, and leadership to ensure successful onboarding and performance.
• Collaborate with a team of over 500 EviCore physician colleagues to ensure consistent, high-quality, evidence-driven clinical decision-making across cases.
• Maintain compliance with applicable state and federal healthcare regulations and industry standards, including Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines.
• Adhere to a fixed weekly work schedule Monday through Friday, with predictable hours and no on-call requirements.
• Utilize company-provided encrypted workstation that must be hard-wired to a modem or router; wireless connections are prohibited.
• Maintain high standards of typing, speaking, and listening proficiency, as these are required for 100% of work time.
• Ensure internet connectivity meets minimum technical requirements: cable broadband or fiber optic service with at least 10 Mbps download and 5 Mbps upload speeds.
• Apply clinical judgment in reviewing a wide range of post-acute care cases to ensure patients receive appropriate, cost-effective, and guideline-aligned care.
• Stay current on evolving healthcare regulations, clinical guidelines, and industry developments relevant to PM&R and post-acute care.
• Contribute to continuous improvement of clinical review processes through feedback and participation in team initiatives.

🎯 Requirements

• M.D. or D.O. with a current, active U.S. state medical license
• Board certified in PM&R by the American Board of Medical Specialties or American Osteopathic Association
• 3 years of relevant clinical experience post residency/fellowship
• Ability to commit to a set weekly work schedule (Monday through Friday)
• Strong computer skills and ability to work autonomously with automated systems and applications
• Meet physical demands of the role including typing, speaking, and listening 100% of work time

🏖️ Benefits

• Benefits start on day one, including medical, vision, dental, and behavioral health programs
• 100% work from home with no commute
• 23 PTO days plus 8 paid holidays annually
• 401(k) with company match
• Reimbursement for continuing medical education
• Eligibility for an annual bonus plan

Skills & Technologies

Fiber

Remote

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The Cigna Group

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About The Cigna Group

The Cigna Group is a global health services company formed in 1982 through the merger of Connecticut General and INA Corporation. It provides medical, dental, disability, life and accident insurance, pharmacy benefit management, and behavioral health services to employers, individuals and government entities. Headquartered in Bloomfield, Connecticut, the company operates in over 30 countries and jurisdictions, serving more than 180 million customer relationships worldwide through its subsidiaries and affiliates.

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