Medical Director – Aetna One Advocate

Job not on LinkedIn

🔥 2 hours ago

🌵 Arizona – Remote

🌵 Arizona – Remote

💵 $174.1k - $374.9k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

👻 Ghost score 0%

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CVS Health Careers

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10,000+ employees

🏥 Healthcare

🛒 Retail

📦 Logistics

Healthcare • Retail • Logistics

CVS Health Careers is the recruitment and employer branding arm of CVS Health, showcasing job opportunities across the company's broad operations—pharmacy retail stores, pharmacy services, health care clinics, distribution warehouses, corporate functions and transportation. The careers site emphasizes purpose-driven work focused on improving access, affordability and quality of health care, and highlights a large workforce (300,000+ employees), inclusive culture, benefits, and hiring resources for applicants.

📋 Description

• Lead utilization management, including predetermination and UM reviews • Apply clinical expertise to support accurate, consistent decisions • Participate in the development, implementation, and evaluation of clinical/medical programs • Expand Aetna's medical management programs to address member needs across the continuum of care • Support Medical Management staff in delivering timely, consistent responses to members and providers • Oversee utilization review and quality assurance activities • Direct case management efforts • Provide clinical expertise and business direction for medical management programs through active participation in clinical team activities • Serve as lead clinical and business liaison to network providers and facilities • Present to and meet with plan sponsors, approximately 15% of the time

🎯 Requirements

• Active, unrestricted MD required • Board certification/eligibility in Neurosurgery, Orthopedic Surgery, General Surgery, or Physical Medicine & Rehabilitation (PM&R) strongly preferred • No prior utilization management or managed care experience required; full training provided • Comfort and experience presenting to external audiences • Strong public speaking and stakeholder communication skills • Collaborative mindset and comfort working in a close, fast-moving clinical team • M.D. or D.O. • Board Certification in an ABMS recognized specialty • Post-graduate direct patient care experience • Availability to work primarily during Pacific Time business hours (8:00 a.m. to 5:00 p.m. PT preferred)

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • CVS Health bonus, commission or short-term incentive program • Equity award program

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