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Medical Director - Spine

https://www.cvshealth.com/ Logo

CVS Health

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Location:
United States

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Category:
-

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Contract Type:
Not provided

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Salary:

174070.00 - 374920.00 USD / Year

Job 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 passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Aetna, a CVS Health Company, a Fortune 6 company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity to help transform health care. We believe that a better care system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources.

Job Responsibility:

  • Expands Aetna's medical management programs to address member needs across the continuum of care
  • Supports the Medical Management staff ensuring timely and consistent responses to members and providers
  • Leads all aspects of utilization review/quality assurance, directing case management Provides clinical expertise and business direction in support of medical management programs through participation in clinical team activities
  • Acts as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams
  • Responsible for predetermination reviews ad reviews of claim determinations, providing clinical, coding, and reimbursement expertise, using multiple computer based applications

Requirements:

  • 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 a Orthopedic Spine OR Neurosurgery, including post-graduate direct patient care experience specifically

Nice to have:

Previous healthcare insurance experience

What we offer:
  • Affordable medical plan options
  • 401(k) plan (including matching company contributions)
  • Employee stock purchase plan
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
  • Paid time off
  • Flexible work schedules
  • Family leave
  • Dependent care resources
  • Colleague assistance programs
  • Tuition assistance
  • Retiree medical access

Additional Information:

Job Posted:
April 05, 2026

Employment Type:
Fulltime
Work Type:
Remote work
Job Link Share:

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