CVS Health Medical Director (Medical Affairs) Providence, Rhode Island
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Position Summary
CVS Health, a Fortune 6 company, has an outstanding opportunity for a Medical Director (Medical Affairs). The Medical Affairs department provides clinical business support to the entire enterprise and provides clinical oversight and mentorship for CVS Health clinical programs.
The Medical Director will report into the Medical Affairs Department and is responsible for clinical support and consultative activities across the PBM.
In this role, you may provide consultative clinical support to Account Management in support of Key Clients as assigned.
Responsibilities include :
- Transacting Utilization Management (UM) activities (prior authorization and appeals) and responding to prescriber inquiries related to UM transactions.
- Providing oversight of CVS Health's clinical programs and commercial client program support.
- Completing assigned medication utilization reviews (PA) and / or medical necessity appeals for commercial clients and governmental programs.
- Participating in inter-rater review activities and quality oversight processes for internal Director UM decisions.
- Performing special clinical investigations and research as requested by the Senior Medical Director.
Required Qualifications
- 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.
- Unrestricted license to practice medicine in the state in which the candidate is located.
Preferred Qualifications
- Combination of five years of management and / or clinical experience in a managed care environment.
- Master’s Degree in Public Health Administration or MBA preferred.
- Internal Medicine or Family Medicine Board Certification highly desired.
- Proficiency in MS Office Suite.
Education
Must be graduate of an accredited Medical School and Residency Program. ABMS or AOA Board Certified in a recognized medical specialty, preferably in a Primary Care field.
Pay Range
The typical pay range for this role is $174,070.00 - $374,900.00. This position is eligible for a CVS Health bonus, commission, or short-term incentive program in addition to the base pay range listed above.
For more detailed information on available benefits, please visit jobs.CVSHealth.com / benefits
We anticipate the application window for this opening will close on : 10 / 31 / 2024.
CVS Health is an equal opportunity and affirmative action employer.
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