Medical Director - Remote

Overview

The Medical Director at CVS Health is responsible for overseeing medical policy implementation and expanding Aetna's medical management programs to meet member needs. This role requires a Texas medical license and focuses on clinical quality and effective use of health care resources.

In Short

• Remote work from home position.
• Oversee medical policy implementation.
• Participate in clinical program development and evaluation.
• Support Medical Management staff with timely responses.
• Focus on utilization review and quality assurance.
• Conduct reviews including Prior Authorization and Appeals.
• Provide clinical expertise and business direction.
• Act as liaison to network providers and facilities.
• Requires Texas medical license.
• Two or more years of health care delivery experience.

Requirements

• Active Texas medical license without encumbrances.
• M.D. or D.O. with board certification.
• Experience in clinical practice and health care industry.
• Preferred: Previous UM experience with a health plan.
• Preferred: Board certification in relevant specialties.

Benefits

• Comprehensive medical plan options.
• 401(k) plan with company matching.
• Employee stock purchase plan.
• No-cost wellness programs.
• Flexible work schedules and paid time off.
• Tuition assistance and family leave.
• Confidential counseling and financial coaching.
• Retiree medical access.
• Additional benefits based on eligibility.