Medical Director

Job not on LinkedIn

🕒 July 21

🦌 Connecticut, Iowa, +2 more states – Remote

🦌 Connecticut – Remote 🌾 Iowa – Remote ❄️ Minnesota – Remote 🤠 Texas – 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

• Provide clinical expertise to promote the delivery of high quality, constituent focused medical care with a focus on clinical and payment policy. • Conduct transactional reviews in support of the appeal process, clinical claim review process, and predetermination of covered benefits in the Commercial and Medicare environments. • Apply clinical coding and reimbursement expertise to ensure alignment and correct application of Aetna policies and practices to service and payment requests. • Proactively use data analysis to identify opportunities for quality improvement and positively influence the effective delivery of quality care services. • Serve as a subject matter expert, internal consultant, and payment policy contributor.

🎯 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. • M.D. or D.O., Board Certification in an ABMS recognized specialty including post-graduate direct patient care experience

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • other resources, based on eligibility