Medical Director – Radiation Oncology

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🔥 3 minutes ago

🇺🇸 United States – Remote

💵 $174.1k - $374.9k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

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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

• Support oncology initiatives throughout the enterprise • Oversee utilization review and quality assurance • Perform predetermination reviews and review claim determinations • Provide input for medical policy implementation • 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, coding and reimbursement expertise • Direct case management when necessary • Develop, implement and evaluate clinical and medical programs • Expand 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 • Provide clinical expertise and business direction through participation in clinical team activities • Act as a business and clinical liaison to network providers and facilities • Travel for team meetings and client-facing meetings 1–2 times per quarter • Participate in weekend, holiday and on-call rotation

🎯 Requirements

• M.D. or D.O. with a current, active, U.S. state medical license that is in good standing • Board certified in Radiation Oncology, recognized by the American Board of Medical Specialties or American Osteopathic Association • Eligible to acquire additional state licensure as required • 3+ years of relevant radiation oncology experience in a patient care or managed care setting post residency • Ability to travel 1–2 times per quarter for team or client-facing meetings • Previous UM experience with a Health Plan / Payor preferred • Previous UM experience as a Physician Advisor in a Health / Hospital system preferred • Participate in a weekend, holiday and on-call rotation

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program • Award target in the company’s 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

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