CVS Health Medical Director - Georgia Gulf States
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.
Position Summary:
Aetna, a CVS Health Company, is one of the oldest and largest national insurers. This is a remote based (work from home) position. Ideal Candidates will reside in Georgia, Louisiana, Alabama, Mississippi or Arkansas and have a medical license without encumbrances in one (1) of those five (5) states.
In the Medical Director role you will provide oversight for medical policy implementation and participate in the development, implementation, and evaluation of clinical/medical programs. You will support the Medical Management staff ensuring timely and consistent responses to members and providers.
Your responsibilities will include overseeing utilization review and quality assurance while being responsible for predetermination reviews and review of claim determinations. This includes Prior Authorization, Pre Certification, Concurrent Reviews, Peer to Peer Calls, First Level Appeals, and Special Projects.
Required Qualifications:
- Two (2) or more years of experience in Health Care Delivery System e.g., Clinical Practice and Health Care Industry.
- Active and current medical license without encumbrances.
- M.D. or D.O., Active and Current Board Certification in an ABMS or AOA recognized specialty including post-graduate direct patient care experience.
Education:
Medical Doctor or Doctor of Osteopathic Medicine
Pay Range:
The typical pay range for this role is: $174,070.00 - $374,920.00.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits, a 401(k) retirement savings plan, and an Employee Stock Purchase Plan. The Company provides a fully-paid term life insurance plan, short-term and long-term disability benefits, and numerous well-being programs.
We anticipate the application window for this opening will close on: 10/27/2024.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
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