Medical Director, Oklahoma Medicaid

October 7

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CVS Health

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

10,000+

Description

• Remote Medical Director for Utilization Management at Aetna, a CVS Health company. • Supports the Aetna Better Health Plan of Oklahoma. • Responsible for timely responses to precertification, concurrent review, and appeal requests. • Engages in Utilization Management, focusing on inpatient and outpatient services. • Part of a centralized team also supporting other states. • Rotating on-call schedule for weekend coverage.

Requirements

• Five or more years of experience providing direct patient care. • Oklahoma state medical license without encumbrances. • M.D. or D.O., Current and Active Board Certification in ABMS or AOA recognized specialty. • Board certification in Internal Medicine/Pediatrics, Internal Medicine, or Family Medicine. • Prior UM experience working at Health Plan / Insurer or experience as a Physician Advisor or working for an Independent Review Organization a Plus. • Preferred Oklahoma residency. • Health plan/payor Utilization Management / Review experience. • Managed Care experience. • Medicaid experience.

Benefits

• Full range of medical, dental, and vision benefits. • 401(k) retirement savings plan available. • Employee Stock Purchase Plan offered for eligible employees. • Fully-paid term life insurance plan provided. • Short-term and long-term disability benefits available. • Numerous well-being programs offered. • Education assistance and free development courses provided. • CVS store discount and discount programs available. • Paid Time Off (PTO) and vacation pay offered. • Paid holidays throughout the calendar year.