Remote Medical Director, Utilization & Policy

9025 CVS Shared Services Resources LLC; Michigan; Hybrid; USD 174,000 - 375,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health, in collaboration with Aetna, is seeking a Medical Director for a remote-based role. You will provide oversight for medical policy implementation and participate in development, implementation, and evaluation of clinical programs across the continuum of care.

Preferred candidates will hold an MD or DO with board certification and have 5+ years in health care delivery. The position supports utilization review, predetermination reviews, and collaboration with network providers to

Qualifications

• Active MD or DO license in good standing.
• Board certification in ABMS or AOA recognized specialty.
• Post-graduate direct patient care experience.

Responsibilities

• Oversee medical policy implementation and clinical programs.
• Lead utilization review, predetermination reviews and peer-to-peer reviews.
• Serve as clinical liaison to network providers and facilities.
• Provide direction for clinical team activities and QA processes.

Skills

Medical license (MD/DO)

Board Certification

Education

Medical Doctor or Doctor of Osteopathic Medicine

Job description

CVS Health, in collaboration with Aetna, is seeking a Medical Director for a remote-based role. You will provide oversight for medical policy implementation and participate in development, implementation, and evaluation of clinical programs across the continuum of care.

Preferred candidates will hold an MD or DO with board certification and have 5+ years in health care delivery. The position supports utilization review, predetermination reviews, and collaboration with network providers to