Medical Director, CVS Health

CVS Health

Location:
United States, Work At Home

Category:
Health and Beauty

Contract Type:
Employment contract

Salary:

174070.00 - 374920.00 USD / Year

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Job Description:

CVS Health seeks a Medical Director for the Medical Affairs department. The role involves providing clinical business support across the enterprise, overseeing clinical programs, facilitating medication utilization reviews, responding to prescriber inquiries, and participating in research projects.

Job Responsibility:

Provide consultative clinical support to Account Management in support of Key Clients as assigned
Transact Utilization Management UM activities (prior authorization and appeals) and respond to prescriber inquiries related to UM transactions
Provide oversight of a portion of CVS Health's clinical programs and commercial client program support
Spend a portion of most days completing assigned medication utilization reviews (PA) and/or medical necessity appeals
Participate in inter-rater review activities and other quality oversight processes for internal Director UM decisions
Perform special clinical investigations and research as requested by the Senior Medical Director, Medical Affairs

Requirements:

Family Medicine or Internal Medicine Board Certification
Minimum of 5 years clinical experience in direct patient care
2 or more years proven experience in clinical outcomes, with a solid understanding of medical statistics, regulatory agencies, and analytic programs
Unrestricted license to practice medicine in the state in which the candidate is located

Nice to have:

Combination of five years of management and/or clinical experience in a managed care environment and health administration
ABMS or AOA Board Certified in a recognized medical specialty, preferably in a Primary Care field
Master’s Degree in Public Health Administration or MBA preferred
UM/QA certification desired
Proficiency in MS Office Suite

What we offer:

Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs 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:
May 14, 2025

Expiration:
June 30, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Medical Director