Location: Remote
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.
Qualifications
- MD/DO/MBBS with board certification in Medical Oncology or Pediatric Oncology.
- Minimum five (5) years’ post-residency experience, with active clinical practice preferred within the past 2 years.
- Current, unrestricted medical license (multiple state licenses preferred or willingness to obtain).
- Demonstrated leadership in practice transformation, value-based care, or clinical quality improvement.
- Strong communication, collaboration, and organizational skills, with proven ability to influence physician behavior.
- Energetic, curious, and passionate about shaping the future of oncology care delivery.
- Not under sanction or exclusion from Medicare/Medicaid programs.
Contact: Alyson Plummer
