Medical Director
8 hours ago
CVS Health is seeking a highly skilled Medical Director to join our team. As a Medical Director, you will play a critical role in overseeing medical policy implementation and providing clinical expertise to support medical management programs.
Key Responsibilities:- Develop, implement, and evaluate clinical/medical programs to address member needs across the continuum of care.
- Provide clinical expertise and business direction in support of medical management programs through participation in clinical team activities.
- Act as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs.
- Predetermination reviews and reviews of claim determinations, providing clinical, coding, and reimbursement expertise.
- 2 or more years of experience in Healthcare Delivery System, e.g., Clinical Practice and Healthcare Industry.
- Active and current state medical license in NC without encumbrances.
- M.D. or D.O., Board Certification in a recognized specialty including post-graduate direct patient care experience.
- Health plan/payor experience.
- Electronic medical systems/record experience.
- Managed Care experience.
CVS Health offers a comprehensive benefits package, including medical, dental, and vision benefits, 401(k) retirement savings plan, and an Employee Stock Purchase Plan. We also provide a fully-paid term life insurance plan, short-term and long-term disability benefits, and numerous well-being programs.
As a Medical Director at CVS Health, you will have the opportunity to work with a talented team of healthcare professionals and contribute to the development of innovative medical management programs. If you are a motivated and experienced healthcare professional looking for a challenging and rewarding role, we encourage you to apply.
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