Medical Director - Spine

Medical Director – Spine

Company	CVS Health
Location	New Mexico, USA, Washington, USA, Kansas, USA, Pennsylvania, USA, North Dakota, USA, Oregon, USA, Delaware, USA, Iowa, USA, California, USA, Washington, DC, USA, Vermont, USA, Wyoming, USA, Montana, USA, Jackson Township, NJ, USA, Florida, USA, Waterbury, CT, USA, Nevada, USA, South Carolina, USA, South Dakota, USA, Georgia, USA, Arizona, USA, Concord, NH, USA, Mississippi, USA, Tennessee, USA, Virginia, USA, Arkansas, USA, Minnesota, USA, Colorado, USA, Nebraska, USA, Rhode Island, USA, Utah, USA, Kentucky, USA, West Virginia, USA, New York, NY, USA, Maryland, USA, Wisconsin, USA, Maine, USA, Massachusetts, USA, North Carolina, USA, Oklahoma, USA, Missouri, USA, Ohio, USA, Indiana, USA, Louisiana, USA, Michigan, USA, Illinois, USA, Alabama, USA, Idaho, USA
Salary	$174070 – $374920
Type	Full-Time
Degrees	MD
Experience Level	Senior

2 or more years of experience in Health Care Delivery System e.g., Clinical Practice and Health Care 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 specifically.

Expands Aetna’s medical management programs to address member needs across the continuum of care.
Supports the Medical Management staff ensuring timely and consistent responses to members and providers.
Leads all aspects of utilization review/quality assurance, directing case management.
Provides clinical expertise and business direction in support of medical management programs through participation in clinical team activities.
Acts as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams.
Responsible for predetermination reviews and reviews of claim determinations, providing clinical, coding, and reimbursement expertise, using multiple computer based applications.