Medical Director – ENT

Job not on LinkedIn

🕒 July 9

🇺🇸 United States – Remote

💵 $174.1k - $374.9k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

👻 Ghost score 23%

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.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New 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

⚕️ 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

• Serve as the clinical Subject Matter Expert for Otolaryngology (ENT) • Conduct utilization management and medical necessity reviews • Support timely and consistent clinical determinations for members and providers • Review prior authorizations, predeterminations, and claim determinations • Provide clinical expertise related to coding, reimbursement, and medical policy • Partner with case management and utilization management teams to support quality patient care • Participate in clinical discussions and interdisciplinary team activities • Act as a clinical liaison with network physicians, provider groups, and healthcare facilities • Contribute to the development and enhancement of medical management programs and initiatives

🎯 Requirements

• 2 or more years of experience in a 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 Otolaryngology • Post-graduate direct patient care experience specifically in Otolaryngology • Strong clinical expertise and understanding of evidence-based medicine • Experience with utilization management, medical policy review, or health plan operations preferred • Previous utilization management experience with a health plan/payor preferred • Excellent communication and collaboration skills

🏖️ Benefits

• Annual bonus potential • Long-Term Incentive (LTI) • 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