Medical Director - South Central Market

14 hours ago

🤠 Texas – Remote

Although this job is listed in Texas, this company may be open to hiring remote in other states.

💵 $174.1k - $374.9k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

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CVS Health

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CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

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

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

📋 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 the Medical Management staff ensuring timely and consistent responses to members and providers. • Oversee utilization review / quality assurance and be responsible for predetermination reviews. • Provide clinical, coding, and reimbursement expertise as well as directing case management when necessary. • Act as lead business and clinical liaison to network providers and facilities.

🎯 Requirements

• Two (2) or more years of experience in Health Care Delivery System e.g., Clinical Practice and Health Care Industry. • Active and current Texas state medical license without encumbrances • M.D. or D.O., Board Certification in an ABMS or AOA 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 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 and many other benefits depending on eligibility.