Medical Director - Spine

CVS Health; Alabama; Remote; USD 174,000 - 375,000; Full time

Job summary

CVS Health is seeking a Medical Director (Spine) to join their team remotely. This role requires expertise in Orthopedic Spine or Neurosurgery, focusing on enhancing medical management programs and supporting clinical quality. The position offers a competitive salary range and comprehensive benefits, making it an excellent opportunity for qualified candidates.

Benefits

Comprehensive benefits including medical, dental, vision

401(k) and stock purchase plans

Paid time off, including holidays and sick leave

Education assistance and employee discounts

Qualifications

• At least 2 years of experience in the Healthcare Delivery System.
• Active and current state medical license without encumbrances.
• Post-graduate direct patient care experience.

Responsibilities

• Expand Aetna's medical management programs to address member needs.
• Lead utilization review and quality assurance.
• Act as a clinical liaison to network providers and facilities.

Skills

Clinical Practice

Healthcare Industry

Clinical Quality

Education

M.D. or D.O.

Board Certification in Orthopedic Spine or Neurosurgery

Job description

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient, and affordable.

Position Summary

Aetna, a CVS Health Company and a Fortune 6 company, is one of the oldest and largest national insurers. This experience gives us a unique opportunity to help transform health care. We believe that a better care system is more transparent and consumer-focused, recognizing physicians for their clinical quality and effective use of health care resources.

This is a remote-based (work at home) position anywhere in the US.

Aetna has an exciting opportunity for a Medical Director (Spine) that can be remote-based. The Medical Director (Spine) will be a Subject Matter Expert (SME) with a background in Orthopedic Spine or Neurosurgery, including post-graduate direct patient care experience. The role involves expanding Aetna's medical management programs to address member needs across the continuum of care, supporting Medical Management staff, leading utilization review and quality assurance, and acting as a clinical liaison to network providers and facilities. Responsibilities also include predetermination reviews and claim determinations, providing clinical, coding, and reimbursement expertise.

Required Qualifications

• At least 2 years of experience in the Healthcare Delivery System, e.g., Clinical Practice and Healthcare Industry.
• Active and current state medical license without encumbrances.
• M.D. or D.O., Board Certification in Orthopedic Spine or Neurosurgery, including post-graduate direct patient care experience.

Preferred Qualifications

• Previous healthcare insurance experience.

Education

• See Required Qualifications for details on experience and licensing.

Pay Range

The typical pay range for this role is $174,070.00 - $374,900.00. This range reflects base salary or hourly rate, depending on position specifics. Actual offers depend on experience, education, geography, and other factors. The role is eligible for bonuses, commissions, or incentives, and may include equity awards.

In addition to compensation, CVS Health offers comprehensive benefits including medical, dental, vision, 401(k), stock purchase plans, life insurance, disability benefits, well-being programs, education assistance, employee discounts, and paid time off, including holidays and sick leave, in accordance with relevant laws and policies.