Medical Director – Medical Policy, Operations

Job not on LinkedIn

October 18

🥔 Idaho – Remote

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

🤠 Texas – Remote

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

+1 more states

🥔 Idaho – Remote 🤠 Texas – Remote 🍁 Vermont – 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

• Participate on work groups as a clinical subject matter expert to identify and promote opportunities to improve the quality and efficiency of health care services. • Apply clinical coding and reimbursement expertise to ensure alignment and correct application of Aetna policies and practices to service and payment requests. • Proactively use data analysis to identify opportunities for quality improvement and positively influence the effective delivery of quality care services. • Be a subject matter expert, internal consultant and payment policy contributor subject matter expertise and internal consultant. • Demonstrate the ability to work within and lead as necessary teams comprised of a diverse group of health delivery professionals in order to manage the business objectives of the company. • Work Collaboratively with the functional areas.

🎯 Requirements

• Five (5) 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 an ABMS 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 for all colleagues 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 • Many other benefits depending on eligibility.