Medical Director - Medicaid (abhva) - Remote Eligible

✨ About The Role

- This role is for a Medical Director supporting the Aetna Better Health Plans, particularly in Virginia. - The position is fully remote, allowing for flexibility in work location while being part of a centralized medical management team. - Responsibilities include overseeing precertification, concurrent review, and appeal requests to ensure efficient operations. - The Medical Director will collaborate with medical management staff to enhance service delivery and member care. - The role requires a commitment to CVS Health's mission of providing human-centric healthcare solutions.

⚡ Requirements

- The ideal candidate will have at least five years of experience in the healthcare delivery system, demonstrating a strong background in clinical practice and the healthcare industry. - A current and active state medical license is essential, along with an M.D. or D.O. degree and board certification in a recognized specialty. - Experience in utilization management or as a physician advisor is highly desirable, indicating a familiarity with health plans and insurers. - Candidates should possess a strong understanding of Medicaid managed care plans and the specific needs of the populations served. - The successful individual will be adept at ensuring timely and consistent communication with members and providers regarding medical management processes.