Medical Director

Job not on LinkedIn

🕒 2 days ago

🌵 Arizona – Remote

🌵 Arizona – Remote

💵 $174.1k - $374.9k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

Apply Now

Find Similar Remote Jobs

Receive Emails For Remote Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

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.

📋 Description

• Support Mercy Care (Aetna Medicaid Business in Arizona) • Provide oversight for medical policy implementation. • Participate in the development, implementation, and evaluation of clinical / medical programs and expand medical management programs to address member needs across the continuum of care. • Support the Medical Management staff ensuring timely and consistent responses to members and providers. • Focus primarily on overseeing utilization review and quality assurance while being responsible for predetermination reviews and review of claim determinations. • 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 to support the effective execution of medical services programs by the clinical teams. • Participate in a weekend, holiday and on-call rotation.

🎯 Requirements

• Two (2) or more years of experience in Health Care Delivery System e.g., Clinical Practice and Health Care Industry. • Active and current medical license without encumbrances • M.D. or D.O., Active and Current Board Certification in an ABMS or AOA recognized specialty including post-graduate direct patient care experience. • Overnight travel up to 10% • AZ medical license without encumbrances

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • comprehensive benefits package