Remote Medical Director, Clinical Programs

CVS Health; Town of Texas (WI); Hybrid; USD 174,000 - 375,000; Full time

Job summary

CVS Health is hiring for a remote clinical program role in the US. You will participate in developing, implementing and evaluating medical programs across the care continuum, while supporting Medical Management staff with timely responses to members and providers.

Responsibilities include prior authorization, peer-to-peer calls, and committee participation as needed. The ideal candidate holds an MD/DO with board certification and an active state license, plus 2+ years in health care delivery.

Qualifications

• Active state medical license without encumbrances.
• MD or DO with board certification and post-graduate direct patient care experience.
• 2+ years of experience in Health Care Delivery System.

Responsibilities

• Develop, implement, and evaluate clinical/medical programs across the care continuum.
• Support Medical Management staff with timely, consistent responses to members and providers.
• Handle Prior Authorization/Pre-Certification/Concurrent Reviews/Peer to Peer calls/First Level Appeals/Committee projects as needed.
• Provide clinical expertise and business direction to support medical management programs within clinical teams.
• Lead business and clinical liaison to network providers and facilities for effective program execution.

Skills

Health care delivery

Medical license

MD/DO board certified

Education

MD/DO

Board Certification

Job description

CVS Health is hiring for a remote clinical program role in the US. You will participate in developing, implementing and evaluating medical programs across the care continuum, while supporting Medical Management staff with timely responses to members and providers.

Responsibilities include prior authorization, peer-to-peer calls, and committee participation as needed. The ideal candidate holds an MD/DO with board certification and an active state license, plus 2+ years in health care delivery.