Full-Time

Medical Director

Confirmed live in the last 24 hours

CVS Pharmacy

CVS Pharmacy

10,001+ employees

Retail pharmacy and healthcare services provider

Healthcare

Compensation Overview

$174.1k - $374.9kAnnually

+ Bonus + Commission + Equity Award Program

Senior

Company Historically Provides H1B Sponsorship

Remote in USA

Must have a North Carolina medical license or be willing to obtain one.

Category
Physicians & Surgeons
Medical, Clinical & Veterinary
Requirements
  • Active and current state medical license in NC state without encumbrances. If no NC license, must be willing to obtain.
  • M.D. or D.O., Board Certification in an ABMS or AOA recognized specialty including post-graduate direct patient care experience.
Responsibilities
  • Provide oversight for medical policy implementation.
  • Participate in the development, implementation, and evaluation of clinical / medical programs and expand Aetna's medical management programs to address member needs across the continuum of care.
  • Support the Medical Management staff ensuring timely and consistent responses to members and providers.
  • Focus primarily on overseeing utilization review / quality assurance and be responsible for predetermination reviews.
  • This includes Prior Authorization / Pre Certification / Concurrent Reviews / Peer to Peer Calls / First Level Appeals / Special Projects and Committee participation when needed.
  • Provide clinical expertise as well as directing case management when necessary.
  • Provide clinical expertise and business direction in support of medical management programs through participation in clinical team activities.
  • Act as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams.

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, beauty items, and general merchandise. CVS Health also functions as a pharmacy benefits manager, serving over 75 million plan members, and has a senior pharmacy care business that assists more than one million patients each year. This integrated approach allows CVS Health to deliver affordable health management solutions, improving access to quality care and health outcomes while aiming to reduce overall healthcare costs. Unlike many competitors, CVS Health combines retail pharmacy services with clinical care and pharmacy benefits management, making it a significant player in the healthcare sector with a goal of helping individuals achieve better health.

Company Stage

Debt Financing

Total Funding

N/A

Headquarters

Woonsocket, Rhode Island

Founded

1963

Growth & Insights
Headcount

6 month growth

-2%

1 year growth

-2%

2 year growth

-2%
Simplify Jobs

Simplify's Take

What believers are saying

  • CVS offers at-home health testing kits, aligning with consumer demand for convenience.
  • The company provides free cash-back services, attracting customers amid rising fees elsewhere.
  • CVS's digital vaccine scheduler enhances customer convenience for flu and COVID-19 vaccinations.

What critics are saying

  • At-home testing kits may reduce in-store foot traffic for health services.
  • Sony's advanced hearing aids could challenge CVS's market share in this category.

What makes CVS Pharmacy unique

  • CVS Health offers a comprehensive pharmacy network with 9,600 retail locations.
  • The company integrates pharmacy benefits management with over 75 million plan members.
  • CVS Health provides specialty pharmacy services, enhancing its healthcare service offerings.

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