Medical Director - Spine

Hispanic Alliance for Career Enhancement; Hartford (CT); 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, focusing on expanding medical management programs and providing clinical support. Candidates must have an MD or DO with relevant board certification and experience in healthcare delivery.

Benefits

Comprehensive medical plans

401(k) and stock purchase plans

Wellness programs

Paid time off

Flexible schedules

Family leave

Qualifications

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

Responsibilities

• Leading case management and clinical expertise in support of medical management programs.
• Managing predetermination reviews and claim determinations.

Skills

Clinical Expertise

Healthcare Delivery System

Utilization Review

Education

MD or DO with 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.

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/quality assurance, and acting as a clinical and business liaison to network providers and facilities.

Responsibilities include:

• Leading case management and clinical expertise in support of medical management programs.
• Managing predetermination reviews and claim determinations, providing clinical, coding, and reimbursement expertise.

Required Qualifications

• At least 2 years of experience in Healthcare Delivery System, including clinical practice and industry.
• Active, 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 above: 2+ years in healthcare delivery, active license, MD or DO with relevant board certification and post-grad experience.

Pay Range

The typical pay range is $174,070.00 - $374,920.00, depending on experience, education, and location. The role is eligible for bonuses, incentives, and equity awards.

Benefits

We offer comprehensive benefits including medical plans, 401(k), stock purchase plans, wellness programs, paid time off, flexible schedules, family leave, and more. For details, visit here.

Application deadline: 06/30/2025. Qualified applicants with arrest or conviction records will be considered in accordance with laws.