Medical Director - Commercial Appeals - Remote

Overview

The Medical Director at CVS Health will oversee medical policy implementation and support Medical Management staff in reviewing appeal cases for denied medical services, focusing on transparency and consumer-focused care.

In Short

• Remote position with a focus on medical policy and appeals management.
• Requires M.D. or D.O. with Board Certification.
• Two or more years of experience in Health Care Delivery Systems.
• Prior experience in Utilization Management is preferred.
• Active state medical license required.
• Provides clinical, coding, and reimbursement expertise.
• Acts as a liaison to network providers and facilities.
• Eligible for bonuses and equity award programs.
• Comprehensive benefits including medical plan options and retirement plans.
• Commitment to fostering a diverse and inclusive workplace.

Requirements

• M.D. or D.O. with Board Certification in an ABMS or AOA recognized specialty.
• Two years of experience in clinical practice or health care industry.
• Active and current medical license.
• Experience in Utilization Management.
• Internal Medicine or Med/Peds background preferred.

Benefits

• Competitive salary with a range of $174,070 - $374,920.
• 401(k) plan with company matching.
• Employee stock purchase plan.
• No-cost wellness programs and confidential counseling.
• Flexible work schedules and paid time off.
• Tuition assistance and family leave options.