Medical Director - Spine

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

Job summary

An established industry player is seeking a Medical Director specializing in Orthopedic Spine or Neurosurgery to join their innovative team. This remote position offers a unique opportunity to impact patient care by expanding medical management programs and supporting clinical staff. The ideal candidate will have a strong background in healthcare delivery, with a focus on quality assurance and utilization review. The role promises competitive compensation and a comprehensive benefits package, making it an exciting opportunity for those passionate about transforming healthcare delivery.

Benefits

Medical benefits

Dental benefits

Vision benefits

Retirement plans

Stock purchase plans

Education assistance

Paid time off

Qualifications

• 2+ years of experience in Clinical Practice and the Healthcare Industry.
• Active state medical license and board certification required.

Responsibilities

• Lead utilization review and quality assurance for medical management.
• Serve as a clinical liaison to network providers and facilities.

Skills

Orthopedic Spine

Neurosurgery

Clinical Practice

Healthcare Delivery System

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, 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, recognizing physicians for their clinical quality and effective use of health care resources.

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

Aetna, a CVS Health Company, 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 and quality assurance, and serving as a clinical and business liaison to network providers and facilities. Responsibilities also include predetermination reviews and claim determinations, providing clinical, coding, and reimbursement expertise.

Required Qualifications

• 2 or more years of experience in the Health Care Delivery System, e.g., Clinical Practice and the 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

• 2 or more years of experience in the Health Care Delivery System.
• 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.

Pay Range

The typical pay range for this role is $174,070.00 - $374,900.00.

This pay range represents the base salary or hourly rate for positions within this job grade. The actual offer will depend on experience, education, geography, and other factors. The role is eligible for bonuses, commissions, or incentive programs, and includes an equity award target.

In addition to compensation, CVS Health offers comprehensive benefits including medical, dental, vision, retirement plans, stock purchase plans, insurance, well-being programs, education assistance, discounts, and paid time off, in accordance with relevant laws and policies.