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Medical Director - Florida - Remote Eligible
Expand Aetna's medical management programs to better address member needs across the continuum of care.
Remote
Senior
$174,070 - 374,920 USD / year
2 weeks ago
CVS Health
CVS Health is a leading pharmacy and healthcare company offering prescriptions, products, and wellness services.
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✨ About The Role
- The Medical Director will provide oversight for medical policy implementation and participate in the development and evaluation of clinical programs.
- This role involves supporting Medical Management staff to ensure timely responses to members and providers.
- Responsibilities include overseeing utilization review, quality assurance, and conducting predetermination reviews.
- The Medical Director will act as a clinical liaison to network providers and facilities, ensuring effective execution of medical services programs.
- Participation in special projects and committee activities may be required as needed.
âš¡ Requirements
- The ideal candidate will possess an active and current medical license in Florida without any encumbrances.
- A Doctor of Medicine (M.D.) or Doctor of Osteopathy (D.O.) degree is required, along with board certification in a recognized specialty.
- Candidates should have post-graduate direct patient care experience, demonstrating a strong clinical background.
- Previous experience in Utilization Management (UM) within a Health Plan or Payor is preferred.
- The successful individual will be adept at overseeing medical policy implementation and expanding medical management programs.
Medical Director - Florida - Remote Eligible
Remote
$174,070 - 374,920 USD / year
Healthcare Administration
About CVS Health
CVS Health is a leading pharmacy and healthcare company offering prescriptions, products, and wellness services.