Medical Director - Spine

Hispanic Alliance for Career Enhancement; Austin (TX); Remote; USD 174,000 - 375,000; Full time

Job summary

A leading health solutions company seeks a Medical Director (Spine) to work remotely. This role requires expertise in Orthopedic Spine or Neurosurgery and involves clinical reviews, supporting medical management staff, and liaising with network providers. The position offers a competitive salary and comprehensive benefits.

Benefits

Affordable medical plans

401(k) with matching

Employee stock purchase plans

Wellness programs

Paid time off

Flexible schedules

Tuition assistance

Qualifications

• 2+ years of experience in Healthcare Delivery System.
• Active state medical license without encumbrances.
• Post-graduate direct patient care experience.

Responsibilities

• Lead utilization review and quality assurance.
• Act as a clinical and business liaison to network providers.
• Conduct predetermination and claims reviews.

Skills

Clinical Practice

Healthcare Delivery System

Clinical Quality

Education

M.D. or D.O.

Board Certification in Orthopedic Spine or Neurosurgery

Job description

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels, and more than 300,000 purpose-driven colleagues — caring for people where, when, and how they choose in a way that is uniquely more connected, more convenient, and more compassionate. And we do it all with heart, each and every day.

Position Summary

Aetna, a CVS Health Company, a Fortune 6 company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity to help transform health care. We believe that a better care system is more transparent and consumer-focused, and it recognizes 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, working from home.

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.

This role involves expanding Aetna's medical management programs to address member needs across the continuum of care, supporting Medical Management staff, leading utilization review/quality assurance, and acting as a clinical and business liaison to network providers and facilities.

Responsibilities include predetermination reviews, claims reviews, and providing clinical, coding, and reimbursement expertise using multiple computer applications.

Required Qualifications

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

Preferred Qualifications

• Previous healthcare insurance experience.

Education

• Same as required qualifications, emphasizing experience and certification.

Pay Range

The typical pay range for this role is $174,070.00 - $374,920.00. Actual offers depend on experience, education, geography, and other factors. The role is eligible for bonuses, commissions, and equity awards.

Benefits

Our benefits include affordable medical plans, 401(k) with matching, employee stock purchase plans, wellness programs, paid time off, flexible schedules, family leave, dependent care resources, tuition assistance, and retiree medical access. For more details, visit our benefits page.

Application window closes on 06/30/2025. Qualified applicants with arrest or conviction records will be considered in accordance with laws.