Medical Director – Spine

This is a fully remote position, open to applicants in Alabama, +32 more states.

📋 Description

• Function as a Medical Director specializing in Spine and serve as a subject matter expert in Orthopedic Spine or Neurosurgery.

• Enhance Aetna’s medical management initiatives throughout the entire care continuum.

• Assist Medical Management personnel by providing timely and consistent feedback to both members and providers.

• Oversee utilization review and ensure quality assurance practices are upheld.

• Manage case management operations.

• Offer clinical expertise and strategic direction through the activities of the clinical team.

• Serve as the primary business and clinical point of contact for network providers and facilities.

• Facilitate the efficient implementation of medical services programs by clinical teams.

• Perform predetermination reviews as well as evaluations of claim determinations.

• Deliver clinical, coding, and reimbursement knowledge utilizing various computer-based applications.

⛳️ Requirements

• Minimum of 2 years of experience within a healthcare delivery system, including clinical practice and the healthcare sector.

• Must possess an active and current state medical license without any encumbrances.

• M.D. or D.O. degree required.

• Board Certification in Orthopedic Spine or Neurosurgery is necessary.

• Direct patient care experience post-graduation is a must.

• Previous experience in healthcare insurance is preferred.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program.

• Target for awards in the company’s equity award program.

• Comprehensive medical coverage.

• Dental coverage provided.

• Vision coverage available.

• Paid time off offered.

• Options for retirement savings.

• Wellness programs accessible.

• Additional resources supporting physical, emotional, and financial well-being.