# Medical Director

**Company**: CVS Health
**Work arrangement**: remote
**Experience**: senior
**Job type**: full-time
**Salary**: $174,070.00 - $374,920.00
**Category**: Healthcare
**Industry**: Healthcare

**Apply**: https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/AZ---Work-from-home/Medical-Director--Aetna-One-Advocate-_R1034262?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/jobs/job_4c87271a-27a

## Description

We're building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.

As a Medical Director on the Aetna One Advocate team, you'll help shape the execution of a multidisciplinary model to guide members toward their best possible health care outcomes.

**Responsibilities**

- Lead utilization management, including predetermination and UM reviews

- Apply clinical expertise to support accurate, consistent decisions

- Participate in the development, implementation, and evaluation of clinical/medical programs

- Help expand Aetna's medical management programs to better address member needs across the continuum of care

- Support Medical Management staff in delivering timely, consistent responses to members and providers

- Oversee utilization review and quality assurance activities

- Direct case management efforts

- Provide clinical expertise and business direction for medical management programs through active participation in clinical team activities

- Serve as lead clinical and business liaison to network providers and facilities, supporting effective execution of medical services programs

- Represent Aetna One Advocate in external-facing presentations and plan sponsor meetings (approx. 15% of time)

**Requirements**

- Active, unrestricted MD required

- Board certification/eligibility in Neurosurgery, Orthopedic Surgery, General Surgery, or Physical Medicine & Rehabilitation (PM&R) strongly preferred

- No prior utilization management or managed care experience required , full training provided

- Comfort and experience presenting to external audiences , strong public speaking and stakeholder communication skills

- Collaborative mindset and comfort working in a close, fast-moving clinical team

**Benefits**

- Comprehensive benefits package, including medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources

**Pay Range**

- $174,070.00 - $374,920.00

## Skills

### Required
- MD
- clinical expertise
- utilization management
- case management

### Nice to have
- Neurosurgery
- Orthopedic Surgery
- General Surgery
- Physical Medicine & Rehabilitation
- public speaking
- stakeholder communication

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Source: [Apply at cvshealth.wd1.myworkdayjobs.com](https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/AZ---Work-from-home/Medical-Director--Aetna-One-Advocate-_R1034262?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)