Medical Director - Medicare Appeals
Clinical Careers Page(2 months ago)
About this role
A Medical Director focused on Medicare appeals at Aetna, a CVS Health company, providing clinical leadership and oversight for the enterprise’s Medicare appeals function. This remote role contributes to Medicare policy development and collaborates with quality and compliance teams to support consistent, compliant adjudication across appeals.
Required Skills
- Medicare Appeals
- Appeals Management
- Utilization Management
- Clinical Supervision
- Medicare Policy
- IRE Monitoring
- Clinical Education
- Quality Compliance
- After-Hours Coverage
Qualifications
- MD or DO
- Active State Medical License
- Board Certification (ABMS or AOA)
About Clinical Careers Page
cvshealth.comCVS 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.
View more jobs at Clinical Careers Page →Apply instantly with AI
Let ApplyBlast auto-apply to jobs like this for you. Save hours on applications and land your dream job faster.
More jobs at Clinical Careers Page
Similar Jobs
Behavioral Health Medical Director – Psychiatrist – National Medicare (Part-time)
Elevance Health(1 month ago)
Utilization Management Appeals Nurse
Humana(1 month ago)
Manager, Home Health Grievances & Appeals
Humana(1 month ago)
Clinical Appeals Nurse
Idaho(11 days ago)
Appeals Medical Director – Internal Medicine
Elevance Health(12 days ago)
Appeals Clinical Team Lead
PacificSource Health Plans(2 months ago)