Medical Director - Spine (, MD, United States) Job at CVS Health, Maryland

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  • CVS Health
  • Maryland

Job Description

At CVS Health, were building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nations leading health solutions company, we reach millions of Americans through our local presence, digital channels, and more than 300,000 purpose-driven colleagues caring for people where, when, and how they choose in a way that is uniquely more connected, more convenient, and more compassionate. And we do it all with heart, each and every day.

Position Summary

Aetna, a CVS Health Company, a Fortune 6 company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity to help transform health care. We believe that a better care system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources.

  • This is a remote-based (work at home) position anywhere in the US.

Aetna has an exciting opportunity for a Medical Director (Spine) that can be remote based, working from home.

The Medical Director (Spine) will be a Subject Matter Expert (SME) with a background in Orthopedic Spine OR Neurosurgery, including post-graduate direct patient care experience.

This role involves expanding Aetna's medical management programs to address member needs across the continuum of care, supporting the Medical Management staff for timely responses, leading utilization review and quality assurance, and acting as a clinical and business liaison to network providers and facilities.

The candidate will be responsible for predetermination reviews and claim reviews, providing clinical, coding, and reimbursement expertise using multiple computer-based applications.

Required Qualifications

  • 2 or more years of experience in the Healthcare Delivery System, e.g., Clinical Practice and Healthcare Industry.
  • Active and current state medical license without encumbrances.
  • M.D. or D.O., Board Certification in Orthopedic Spine OR Neurosurgery, including post-graduate direct patient care experience.

Preferred Qualifications

  • Previous healthcare insurance experience.

Education

  • Same as required qualifications, emphasizing the need for experience and certification in Orthopedic Spine or Neurosurgery.

Pay Range: $174,070.00 - $374,920.00

This pay range represents the base salary or hourly rate for positions within this job grade. Actual offers depend on experience, education, geography, and other factors. The role is eligible for bonuses, commissions, or incentive programs, including equity awards.

Our people fuel our future. We are committed to fostering a workplace where every colleague feels valued and belongs.

Benefits

We offer comprehensive benefits including medical options, 401(k) with matching, employee stock purchase plans, wellness programs, counseling, financial coaching, paid time off, flexible schedules, family leave, dependent care resources, tuition assistance, retiree medical, and more.

For more information, visit our careers page. The application window closes on 07/18/2025.

Qualified applicants with arrest or conviction records will be considered in accordance with applicable laws.

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Job Tags

Hourly pay, Full time, Local area, Remote work, Flexible hours,

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