Medical Director

5 days ago

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CVS Health

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Retail • Pharmacy Benefits Management • Health Insurance • Health Care • Pharmacy

10,000+

Description

• Provide oversight for medical policy implementation • Participate in the development, implementation, and evaluation of clinical/medical programs • Expand Aetna's medical management programs to address member needs • Support Medical Management staff ensuring timely responses to members and providers • Oversee utilization review/quality assurance • Responsible for predetermination reviews, including Prior Authorization and related activities • Provide clinical expertise as lead business and clinical liaison to network providers

Requirements

• M.D. or D.O., Board Certification in an ABMS or AOA recognized specialty • Active and current state medical license • Previous UM experience with a Health Plan/Payor

Benefits

• Full range of medical, dental, and vision benefits • 401(k) retirement savings plan • Employee Stock Purchase Plan • Fully-paid term life insurance plan • Short-term and long-term disability benefits • Well-being programs • Education assistance • Free development courses • CVS store discount • Paid Time Off (PTO) • Paid holidays throughout the calendar year • Sick time and other time off per state law and Company policies