Medical Director – Commercial

Job not on LinkedIn

🕒 July 24

🏈 Alabama, Colorado, +35 more states – Remote

🏈 Alabama – Remote ⛰️ Colorado – Remote 🦌 Connecticut – Remote 🏛️ District of Columbia – Remote 🐊 Florida – Remote 🌺 Hawaii – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦞 Maine – Remote 🌾 Nebraska – Remote 🎰 Nevada – Remote 🗻 New Hampshire – Remote 🏖️ New Jersey – Remote 🌶️ New Mexico – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🌾 North Dakota – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote ⛰️ West Virginia – Remote 🧀 Wisconsin – Remote

💵 $174.1k - $374.9k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

👻 Ghost score 14%

What it means: how likely this posting is sitting open without active hiring.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.

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

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

• Participate in the development, implementation, and evaluation of clinical/medical programs • Expand Aetna’s medical management programs to address member needs across the continuum of care • Support Medical Management staff by ensuring timely and consistent responses to members and providers • Conduct Prior Authorization, Pre-Certification, Concurrent Reviews, Peer to Peer calls, and First Level Appeals • Participate in special projects and committees as needed • Provide clinical expertise and business direction through participation in clinical team activities • Act as lead business and clinical liaison to network providers and facilities • Support effective execution of medical services programs by clinical teams

🎯 Requirements

• 2 or more years of experience in Health Care Delivery System, such as 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 • Post-graduate direct patient care experience • Five or more years of direct patient care experience (preferred) • Previous UM experience with a health plan/payor (preferred) • Electronic medical systems/record experience (preferred) • Managed Care experience (preferred) • Board certification in Internal Medicine, Family Medicine, Emergency Medicine, or General Surgery (preferred)

🏖️ Benefits

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