Medical Director

Job not on LinkedIn

🔥 0 minutes ago

🌾 Iowa – Remote

🌾 Iowa – Remote

💵 $174.1k - $374.9k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

CVS Health Careers

WebsiteLinkedInAll Job Openings

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

• Provide oversight for medical policy implementation • Participate in the development, implementation, and evaluation of clinical and medical programs • Expand Aetna's medical management programs to address member needs across the continuum of care • Support Medical Management staff in providing timely and consistent responses to members and providers • Oversee utilization review and quality assurance • Conduct predetermination reviews and review claim determinations • Perform prior authorization, pre-certification, concurrent reviews, peer-to-peer calls, and first-level appeals • Participate in special projects and committees as needed • Provide clinical, coding, and reimbursement expertise • Direct case management when necessary • Provide clinical expertise and business direction for medical management programs through clinical team activities • Serve as lead business and clinical liaison to network providers and facilities

🎯 Requirements

• Five (5) or more years of experience in a health care delivery system, such as clinical practice and the 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 • Post-graduate direct patient care experience • Preferred: Previous utilization management experience with a health plan/payor or as a physician advisor in a healthcare system • Preferred: Board certification in Internal Medicine, Family Medicine, Emergency Medicine, Med/Peds, or General Surgery

🏖️ Benefits

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

📊 Check your resume score for this job

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

Upload Resume