Medical Director (Medical Policy & Operations) - Remote

Overview

As a Medical Director at CVS Health, you will provide clinical expertise and business direction in support of medical management programs, ensuring high-quality medical care delivery.

In Short

• Remote position available anywhere in the United States.
• Provide clinical support and business direction for medical management programs.
• Participate in work groups to improve healthcare services.
• Apply expertise in clinical coding and reimbursement.
• Utilize data analysis for quality improvement.
• Lead diverse teams of health delivery professionals.
• Support appeal processes and clinical claim reviews.
• Collaborate with various functional areas.
• Must hold an active state medical license.
• Five years of experience in healthcare delivery is required.

Requirements

• M.D. or D.O. with board certification.
• Experience in health plan or payor environments preferred.
• Knowledge of HCPCS/CPT coding.
• Strong written and verbal communication skills.
• Willingness to learn about Aetna policies.

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.