CVS Health - Medical Director - Medical Affairs (Oncology)
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
CVS Health, a Fortune 4 company, has an outstanding opportunity for a Medical Director - Medical Affairs. We need a Board Certified Oncologist for this opportunity.
The Medical Affairs department provides clinical business support to the entire enterprise and provides clinical oversight and mentorship for CVS Health clinical programs. The Medical Director (Medical Affairs) will report into the Medical Affairs Department and is responsible for clinical support and consultative activities across the PBM.
Responsibilities
- Provide consultative clinical support to Account Management in support of Key Clients as assigned.
- Transact Utilization Management (UM) activities (prior authorization and appeals) and respond to prescriber inquiries related to UM transactions.
- Model the highest levels of clinical integrity, knowledge, and cross-functional thinking and decision-making.
- Provide oversight of a portion of CVS Health's clinical programs and commercial client program support.
- Complete assigned medication utilization reviews (PA) and/or medical necessity appeals for commercial clients and governmental programs.
- Participate in inter-rater review activities and other quality oversight processes for internal Director UM decisions.
- Perform special clinical investigations and research as requested by the Senior Medical Director, Medical Affairs.
Required Qualifications
- Minimum of 5 years clinical experience in direct patient care.
- 2 or more years proven experience in clinical outcomes, with a solid understanding of medical statistics, regulatory agencies, and analytic programs.
- Unrestricted license to practice medicine in the state in which the candidate is located.
Preferred Qualifications
- Combination of five years of management and/or clinical experience in a managed care environment.
- Master’s Degree in Public Health Administration or MBA preferred.
- Internal Medicine or Family Medicine Board Certification highly desired.
- Proficiency in MS Office Suite.
Education
- Must be graduate of an accredited Medical School and Residency Program.
- ABMS or AOA Board Certified in a recognized medical specialty, preferably in a Primary Care field.
- Required annual Continuing Medical Education (CME) up to date.
Pay Range
The typical pay range for this role is: $174,070.00 - $374,900.00.
Benefits
The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long-term disability benefits.
We anticipate the application window for this opening will close on: 10/31/2024.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer.
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