CVS Health - Medical Director - Medicaid (FL)
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:
Ready to take your Medical Director skills to the next level with a Fortune 6 company? Checkout this opportunity with Aetna, a CVS Health company!
Aetna operates Medicaid managed care plans in sixteen states, primarily supporting the Aetna Better Health of Florida. This Medical Director will be a 'Work from Home' position, part of a centralized team that supports the Medical Management staff.
The Medical Director will ensure timely responses to members and providers related to precertification, concurrent review, and appeal requests. This position is primarily responsible for Utilization Management, including prior authorization and concurrent review.
Required Qualifications:
- Five or more years of experience in Health Care Delivery System e.g., Clinical Practice and Health Care Industry.
- Active and current Florida state medical license without encumbrances.
- M.D. or D.O., Current and Active Board Certification in ABMS or AOA recognized specialty.
- Post-graduate direct patient care experience.
- Pediatrics, Internal Medicine-Pediatric, Family Medicine Specialty Preferred.
- Prior UM experience working at Health Plan / Insurer or experience as a Physician Advisor.
Preferred Qualifications:
- Electronic medical systems/record experience.
- Managed Care experience.
- Medicaid experience.
Education:
M.D. or D.O., Board Certification in ABMS or AOA recognized specialty including post-graduate direct patient care experience.
Pay Range:
The typical pay range for this role is $174,070.00 - $374,920.00. This pay range represents the base salary for all positions in the job grade within which this position falls.
In addition to compensation, enjoy a full range of medical, dental, and vision benefits, a 401(k) retirement savings plan, and an Employee Stock Purchase Plan. CVS Health also offers numerous well-being programs, education assistance, and Paid Time Off (PTO).
We anticipate the application window for this opening will close on: 11/29/2024.
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. 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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