Remote Medical Director: Policy, Care Management & Impact

CVS Health; Florida; Hybrid; USD 174,000 - 375,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Wellness programs

Job summary

CVS Health is seeking a Medical Director to oversee medical policy implementation and clinical program evaluation in a remote role preferably based in Florida. You will support Medical Management, ensure timely responses to members and providers, and provide expert guidance on utilization review and case management across the continuum of care.

The position requires an MD or DO with board certification and a current state license, with potential for bonus incentives and equity participation.

Qualifications

• Five or more years of experience in Health Care Delivery System.
• Active and current state medical license (FL preferred).
• MD or DO with ABMS or AOA board certification.

Responsibilities

• Oversee medical policy implementation and development of clinical programs.
• Provide clinical, coding, and reimbursement expertise to medical management programs.
• Lead utilization review activities including predeterminations, authorizations, and appeals.

Skills

Health care delivery experience

Medical license

Education

MD or DO

ABMS/AOA board certification

Job description

CVS Health is seeking a Medical Director to oversee medical policy implementation and clinical program evaluation in a remote role preferably based in Florida. You will support Medical Management, ensure timely responses to members and providers, and provide expert guidance on utilization review and case management across the continuum of care.

The position requires an MD or DO with board certification and a current state license, with potential for bonus incentives and equity participation.