A Day in the Life of an AMD (Associate Medical Director)
A typical day for an AMD begins in their home office…
1. Intake – Cases come in and are filtered through artificial intelligence then reviewed by a non-clinical decision support team.
2. Nurse Review - Cases are reviewed by the EviCore nurse if an outcome cannot be determined by the non-clinical decision support team.
3. AMD Review - Cases are escalated to the AMD team if an outcome cannot be determined during the nurse review.
4. AMD Review Process - Cases are reviewed on the EviCore portal or on physician consultation (peer-to-peer) calls to determine the appropriate evidence-based clinical decision.
EviCore AMDs will typically spend 50% of the day reviewing cases within the EviCore portal and 50% conducting "peer-to-peer" (P2P) telephone calls. These calls are usually with the requesting provider, focusing on the reconsideration of a denied case. This model allows AMDs to make a difference by supporting over 100,000 patients annually, far more than could be supported in private practice or hospital-based care.
Performance is measured by accuracy and productivity metrics (# cases per hour/day and # of P2Ps achieved). Decisions for approval/denials are 80% driven by EviCore's evidence-based guidelines and 20% by the AMD's individual expertise.
After training, each AMD new hire is assigned a mentor and access to Team Captains that represent each program. AMDs are also presented with an internal network of EviCore physicians, covering a multitude of specialties, who will act as resources for case review advice and input.
A new AMD can expect to be fully trained and productive in their role within 6 months.
Areas for growth include being a Health Plan Liaison or Team Captain. Depending on specialization, the AMD may be consulted on their clinical expertise, or the ongoing evolution and maintenance of EviCore's evidence-based guidelines and 20% by the AMD's individual expertise.