CVS Health Medical Director - New England Region
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Position Summary
Aetna, a CVS Health Company, is one of the oldest and largest national insurers. We believe that a better care system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources.
This is a remote based (work from home) position for the New England Region. The preferred candidate will reside in Connecticut, Rhode Island, Massachusetts, Vermont, New Hampshire, or Maine.
The Medical Director will be responsible for overseeing the utilization review for health systems and providers in New England. An ideal candidate would have experience performing in-hospital utilization reviews and other quality activities. The Medical Director will be required to have a New England state medical license without encumbrances, or the ability to obtain the license within a reasonable timeframe.
As a Medical Director, you will focus primarily on overseeing utilization review and quality assurance of inpatient hospitalizations, prior authorizations, and appeals. You will participate in the development, implementation, and evaluation of clinical/medical programs and expand Aetna's medical management programs to address member needs across the continuum of care.
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.
Preferred Qualifications:
- Residence in one of the states in the New England Region.
- Previous UM experience with a Health Plan/Payor.
- Previous UM experience as a Physician Advisor in a Health/Hospital system.
- Board Certification in Internal Medicine, Family Medicine, or Emergency Medicine Preferred.
Education:
Medical Doctor or Doctor of Osteopathic Medicine
Pay Range:
The typical pay range for this role is $174,070.00 - $374,920.00. This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography, and other relevant factors.
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. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.
We anticipate the application window for this opening will close on: 11/29/2024
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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