Medical Director – Medicare, Medical Policy & Operations
CVS Health
Medical Director – Medical Policy, Operations
CVS Health
full-time
Posted on:
Location Type: Remote
Location: Remote • Idaho, Texas, Vermont • 🇺🇸 United States
Visit company websiteSalary
💰 $174,070 - $374,920 per year
Job Level
Lead
About the role
- Participate on work groups as a clinical subject matter expert to identify and promote opportunities to improve the quality and efficiency of health care services.
- Apply clinical coding and reimbursement expertise to ensure alignment and correct application of Aetna policies and practices to service and payment requests.
- Proactively use data analysis to identify opportunities for quality improvement and positively influence the effective delivery of quality care services.
- Be a subject matter expert, internal consultant and payment policy contributor subject matter expertise and internal consultant.
- Demonstrate the ability to work within and lead as necessary teams comprised of a diverse group of health delivery professionals in order to manage the business objectives of the company.
- Work Collaboratively with the functional areas.
Requirements
- Five (5) or more years of experience in Health Care Delivery System e.g., Clinical Practice and Health Care Industry.
- Active and current state medical license without encumbrances.
- M.D. or D.O., Board Certification in an ABMS recognized specialty including post-graduate direct patient care experience.
Benefits
- Affordable medical plan options
- 401(k) plan (including matching company contributions)
- Employee stock purchase plan
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
- Paid time off
- Flexible work schedules
- Family leave
- Dependent care resources
- Colleague assistance programs
- Tuition assistance
- Retiree medical access
- Many other benefits depending on eligibility.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
clinical codingreimbursement expertisedata analysisquality improvement
Soft skills
leadershipcollaborationconsultingcommunication
Certifications
M.D.D.O.Board Certification
