Medical Director – Commercial
CVS Health
full-time
Posted on:
Location Type: Remote
Location: Remote • North Carolina • 🇺🇸 United States
Visit company websiteSalary
💰 $174,070 - $374,920 per year
Job Level
Lead
About the role
- Collaboratively implement medical policy
- Participate in the development, implementation, and evaluation of clinical/medical programs
- Promote Aetna's medical management programs and the Employer’s resources to address member needs across the continuum of care
- Support the Medical Management staff ensuring timely and consistent responses to members and providers
- Oversee utilization review/quality assurance
- Provide clinical guidance to support case management activity
- Provide clinical expertise and business direction in support of medical management programs through participation in clinical team activities
- Act as a lead business and clinical liaison to account teams and health care providers to support the effective execution of medical services programs by the clinical teams
Requirements
- 2 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
- Experience in the Southern region (e.g., TN, NC, SC, AL, GA) and licensed in NC or willing to get NC license (lives in IMLC state)
- M.D. or D.O., Board Certification in a recognized specialty including post-graduate direct patient care experience.
- Health plan/payor experience (preferred)
- Managed Care experience (preferred)
- Electronic medical systems/record experience (preferred)
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
- Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and 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 programs developmentutilization reviewquality assurancecase managementmedical managementpost-graduate direct patient care
Soft skills
collaborationclinical guidancebusiness directioncommunicationleadership
Certifications
M.D.D.O.Board Certificationactive state medical license