Medical Director (Medical Policy & Operations)

Clinical Careers Page(2 months ago)

RemoteFull TimeSenior$174,070 - $374,920Medical Policy & Operations

About this role

A Medical Director at Aetna (a CVS Health company) provides clinical leadership and business direction for medical management and payment policy initiatives. The role supports development and alignment of clinical and coding policy to promote high-quality, compliant care delivery. This position is remote and open to candidates located anywhere in the United States.

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Required Skills

Clinical Expertise
Medical Policy
Clinical Coding
Claims Review
Appeals
Reimbursement
Data Analysis
Communication
Team Leadership
Collaboration

Qualifications

M.D. or D.O.
Board Certification
Active State Medical License

About Clinical Careers Page

cvshealth.com

CVS Health is America's leading health solutions company, providing integrated services across retail pharmacy (CVS Pharmacy), pharmacy benefits management (CVS Caremark), and health insurance (Aetna). The company offers pharmacy services, health plans, clinical care (including MinuteClinic), and health-and-wellness programs for consumers, employers, and government payers. By combining a large national retail footprint with claims processing, care management, and clinical services, CVS Health aims to coordinate care, lower costs, and improve health outcomes. Businesses and consumers use its solutions for medication management, plan administration, and in-person and virtual care.

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