Medical Director
15 hours ago
CVS Health is seeking a highly skilled Medical Director to join our Medical Affairs team. As a Medical Director, you will be responsible for providing clinical support and consultative activities across our Pharmacy Benefit Management (PBM) organization.
Key Responsibilities- Provide clinical oversight and mentorship for CVS Health clinical programs, PBM Clinical Quality activities, and consultative support to the P&T process, formulary development, drug information services, and pipeline activities.
- Transact Utilization Management (UM) activities, including prior authorization and appeals, and respond to prescriber inquiries related to UM transactions and CVS Health coverage policies.
- 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.
- 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.
- Combination of five years of management and/or clinical experience in a managed care environment and health administration, including adequate clinical experience in direct patient care and working with professionals at different levels as a teammate.
- Master's Degree in Public Health Administration or MBA preferred, UM/QA certification desired.
- Internal Medicine or Family Medicine Board Certification highly desired.
- 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 (Internal medicine, Family Medicine).
- Possess an unrestricted active license to practice medicine in a State, Territory, Commonwealth of the United States, or the District of Columbia.
CVS Health offers a competitive salary and benefits package, including a fully-paid term life insurance plan, short-term and long-term disability benefits, and a 401(k) retirement savings plan. Eligible employees may also participate in the Company's Employee Stock Purchase Plan. In addition, CVS Health provides a range of well-being programs, education assistance, and free development courses to support the growth and development of our employees.
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