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Physician Oncology-Medical Oncology - Competitive Salary

Evolent

Job Description

Lead the Transformation in Oncology Care

At Evolent, we’re redefining how care is delivered for individuals facing cancer. As a Performance Suite Medical Director in Medical Oncology, you will play a pivotal role in advancing value-based care models that prioritize clinical excellence, patient-centered outcomes, and system-wide impact. This role offers the opportunity to collaborate with top-tier clinicians, influence care pathways, and drive innovation in one of the most critical areas of health care. If you're passionate about making a measurable difference in oncology, this is your platform to lead with purpose.

In this role, you will combine your clinical oncology expertise with a focus on value-based strategy and transformation . Unlike traditional medical review roles that emphasize volume throughput, this position integrates utilization management with collaborative engagement and innovation.

Core Responsibilities

  • Clinical Review & Peer Collaboration

    • Serve as the physician reviewer for oncology cases that do not initially meet medical necessity criteria, applying evidence-based guidelines to ensure high-quality and cost-effective care.

    • Conduct peer-to-peer discussions with requesting oncologists—not only to explain determinations but to partner in driving practice patterns aligned with value and quality outcomes .

    • Support clinical reviewers as a subject matter expert and resource.

  • Practice & Physician Engagement

    • Actively participate in engagement sessions with oncology practices , sharing best clinical practices and supporting broader adoption of evidence-based pathways.

    • Foster trusted peer relationships with oncologists to encourage sustainable behavior change that improves patient outcomes.

    • Support practice-level transformation initiatives that reduce unwarranted variation and enhance quality.

  • Internal Strategy & Value Initiatives

    • Collaborate with Evolent’s clinical leadership on the design, build, and execution of new value initiatives in oncology .

    • Provide input on innovation opportunities, clinical algorithms, and models of care that support transformation in specialty care.

    • Partner with operational and analytic teams to assess the impact of interventions and identify opportunities for continuous improvement.

    • Participate in audit processes to validate accuracy of advance payment model payouts, ensuring alignment with clinical documentation, performance metrics, and contractual expectations.

  • Compliance & Quality

    • Ensure all reviews and engagements align with URAC, NCQA, and internal quality standards.

    • Document peer interactions and clinical decisions in a timely and accurate manner.

    • Participate in training and inter-rater reliability processes.

Vacancy posted 4 days ago
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