Medical Director – Aetna One Advocate

Job not on LinkedIn

November 2

🥔 Idaho – Remote

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

🍂 Massachusetts – Remote

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

+1 more states

🥔 Idaho – Remote 🍂 Massachusetts – 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

• Partner with other Advocate team members to holistically assess member’s needs • Collaborate with treating providers through personalized, creative solutions to help member’s meet their health care needs. • Lead the clinical staff in the coordination of quality care on behalf of members • Conduct educational and clinical rounds with A1A clinical staff • Provide clinical expertise and business direction in support of medical management and utilization review programs through participation in clinical team activities including precertification, concurrent review/discharge planning, case management, disease management and quality management • Provide clinical guidance in promoting member quality of care and reviewing/addressing potential lapses • Act to engage providers and facilities in improving the quality of care delivered to our members and assure that our shared relationships are maintained and improved • Proactively use data analysis and periodic assessments to identify opportunities for quality improvement • Work collaboratively with other functional areas that interface with medical management including provider relations, sales, benefits, healthcare delivery, national medical services and national accounts to achieve the business goals

🎯 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.

🏖️ 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 and many other benefits depending on eligibility