Medical Director – Commercial

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2 days ago

🥔 Idaho – Remote

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

🦬 Montana – Remote

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

+1 more states

🥔 Idaho – Remote 🦬 Montana – Remote 🤠 Texas – Remote

💵 $174.1k - $374.9k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

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CVS Health

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Healthcare Insurance • Retail • Wellness

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.

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

📋 Description

• 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, and the dedicated Account Team & Employer • 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 • M.D. or D.O., Board Certification in a recognized specialty including post-graduate direct patient care experience • Health plan/payor experience • Managed Care experience • Electronic medical systems/record experience

🏖️ 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