Description
We're building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.
At CVS Health®, you'll be surrounded by colleagues who care deeply, innovate with purpose, hold themselves accountable and prioritize safety and quality in everything they do.
This role requires Board Certification in Orthopedic Spine OR Neurosurgery.
The starting base salary for this role is $300K.
As a Medical Director (Spine), you will be a Subject Matter Expert (SME) with a background in Orthopedic Spine OR Neurosurgery, including post-graduate direct patient care experience specifically.
Your responsibilities will include:
- Expanding Aetna's medical management programs to address member needs across the continuum of care.
- Supporting the Medical Management staff to ensure timely and consistent responses to members and providers.
- Leading all aspects of utilization review/quality assurance, directing case management.
- Providing clinical expertise and business direction in support of medical management programs through participation in clinical team activities.
- Acting as a lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams.
- Conducting predetermination reviews and reviews of claim determinations, providing clinical, coding, and reimbursement expertise, using multiple computer-based applications.
Required Qualifications:
- 2 or more years of experience in Health Care Delivery System, e.g., Clinical Practice and Health Care Industry.
- Active and current state medical license without encumbrances.
- M.D. or D.O., Board Certification in Orthopedic Spine OR Neurosurgery, including post-graduate direct patient care experience specifically.
Preferred Qualifications:
- Previous healthcare insurance experience.
Benefits: This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
The typical pay range for this role is: $174,070.00 - $374,920.00.