At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. 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 multiple states and this role supports the Aetna Better Health of West Virginia primarily, and the Southeast Region (FL, KY and LA). This Medical Director will be a "Work from Home" position primarily supporting the Aetna West Virginia plan; but part of a centralized team that supports the Medical Management staff. The Medical Director will ensure timely and consistent responses to members and providers related to precertification, concurrent review, and appeal request. This position is primarily responsible for Utilization Management, including prior authorization and pre certification as well as concurrent review. Cases could focus on inpatient or outpatient, acute and post-acute as well as peer to peer calls and first level appeals.
M.D. or D.O., Board Certification in ABMS or AOA recognized specialty including post-graduate direct patient care experience.
The typical pay range for this role is: $174,070.00 - $374,920.00
This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people. We take pride in our comprehensive and competitive mix of pay and benefits investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
We anticipate the application window for this opening will close on: 07/31/2025 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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