eviCore healthcare

The core of our business is known as utilization management. Utilization management (UM) ensures that healthcare services are provided only when they are medically appropriate and meet standards for high quality, safe, and cost-effective care. Guided by a set of evidenced-based clinical guidelines, our teams make the connection between patients, provider, and plan to ensure every health plan member receives the most appropriate care, while avoiding unnecessary cost and medical risk.

The Prior Authorization (PA) process is one of the many aspects of UM that eviCore manages. PA is the process of reviewing requests for medical services and treatments for medical necessity and appropriateness. Learn more about the prior authorization process via the video above.

Doing something meaningful starts with a simple decision, a commitment to changing lives. When you work with us, you’ll continue in our mission to help those we serve navigate the healthcare system, find the right care path, and enable the best outcomes. Whether you’re in customer service, nursing, tech, or another area, your work will have a direct impact on our clients and patients and empower the improvement of care. If this sounds exciting to you, join us! We’re looking for people who are poised to take ownership and see things through- no matter what the challenge- and are self-starters who use their problem-solving skills to prompt more focused action and improved results. Bring your commitment: we’ll enable you to get things done and help you make a real difference.

To do great work, you need to feel supported along the way. Here, you’ll find authentic teams that work together every day to carry out our mission in an empathetic and collaborative environment. But while a pat on the back or a “job well done” is nice, when it comes to our total rewards philosophy, we know you need more. Our total rewards strategy includes our comprehensive health plan (medical, dental, and vision) that starts on your first day; 401K with company match; tuition reimbursement; and paid time off, including holidays, caregiver leave, and company paid community service hours.

Our culture is defined by five core values: we care deeply about our customers, patients and co-workers; we innovate and adapt; we act with speed and purpose; we partner, collaborate and keep our promises; and we create a better future - together. We carry our values with us every day. By always being true to our values and each other, we achieve great things together.