Medical Director - Spine

CVS Health • Milwaukee, WI • 5d ago

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

As the nation's 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) based anywhere in the US.

Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Spine) that can be remote based, work 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 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 ad reviews of claim determinations, providing clinical, coding, and reimbursement expertise, using multiple computer based applications.

Required Qualifications

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 a Orthopedic Spine OR Neurosurgery, including post-graduate direct patient care experience specifically.

Preferred Qualifications

Previous healthcare insurance experience.

Education

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 a Orthopedic Spine OR Neurosurgery, including post-graduate direct patient care experience specifically. Neurosurgery, including post-graduate direct patient care experience specifically.

Pay Range

The typical pay range for this role is:

$174,070.00 - $374,920.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan .

No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 07/18/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Similar Jobs

Physical Therapist Home Care Dodge

HORIZON HOME CARE & HOSPICE INC • Milwaukee, WI • 1d ago

Hospital & Medical

JOB REQUIREMENTS: Honored to be recognized as a 9-time Top Workplace a\" APPLY TODAY to join our growing organization!To some people, home is a place. To others, it\'s a feeling. To us, it\'s whatever our patients need i...

1d ago

Go to Apply

Physical Therapist - Float

ATI Physical Therapy • New Berlin, WI • 1d ago

Hospital & Medical

Overview Are you a Physical Therapist looking to thrive in a supportive, balanced environment? Join ATI, a leader in Physical Therapy, where you'll be part of a team redefining MSK care. With a mission to deliver excepti...

1d ago

Go to Apply

Speech Therapist Home Care Oak Creek

HORIZON HOME CARE & HOSPICE INC • Milwaukee, WI • 1d ago

Hospital & Medical

JOB REQUIREMENTS: To some people, home is a place. To others, it\'s a feeling. To us, it\'s whatever our patients need it to be, wherever they are. Horizon is a home care and hospice provider built on a foundation of car...

1d ago

Go to Apply

Registered Nurse

ST MARY'S HOSPITAL-MILWAUKEE • Milwaukee, WI • 1d ago

Hospital & Medical

JOB REQUIREMENTS: Provide direct nursing care in accordance with established policies, procedures and protocols of the healthcare organization. Implement and monitor patient care plans. Monitor, record and communicate pa...

1d ago

Go to Apply

Medical Planner

HAMMEL GREEN & ABRAHAMSON INC • Milwaukee, WI • 2d ago

Hospital & Medical

JOB REQUIREMENTS: Medical Planner Job Locations US-WI-Milwaukee Job ID 2024-3003 Category Architecture Position Type Regular Full-Time # of Openings 1 Posted Date 22 hours ago(12/3/2024 2:35 PM) Overview: Bring your desi...

2d ago

Go to Apply

Medical Science Writer

MCW: SARGEANT HEALTH CENTER • Milwaukee, WI • 2d ago

Hospital & Medical

JOB REQUIREMENTS: Position Description: Every great life-changing discovery begins the same way-with new knowledge. It can change everything, from a single life to the future of entire communities. That\'s why academic m...

2d ago

Go to Apply

Medical Laboratory Scientist/Technician

WISCONSIN DIAGNOSTIC LABORATORIES • Milwaukee, WI • 2d ago

Hospital & Medical

JOB REQUIREMENTS: Perform complex medical laboratory tests for diagnosis, treatment, and prevention of disease. May train or supervise staff. Performs waived, moderate complexity, and high complexity testing on patient s...

2d ago

Go to Apply

PRN Physical Therapist (PT)

Enhance Rehabilitation • Brookfield, WI • 2d ago

Hospital & Medical

Enhance Rehabilitation is currently seeking qualified Physical Therapists candidates to join our dynamic team. As an Enhance Rehabilitation Physical Therapist, you will be a part of growing team providing the highest qua...

2d ago

Go to Apply

PHYSICAL THERAPIST ASSISTANT

FROEDTERT HEALTH GROUP • Menomonee Falls, WI • 2d ago

Hospital & Medical

JOB REQUIREMENTS: Discover. Achieve. Succeed. #BeHere Location: US:WI:MENOMONEE FALLS at our CP-NORTH HILLS HEALTH CENTER facility. This job is ON - SITE. FTE: 0.001000 Shift: Shift 1 Job Summary: Ideal candidate will ei...

2d ago

Go to Apply

Interior Designer Healthcare

HAMMEL GREEN & ABRAHAMSON INC • Milwaukee, WI • 2d ago

Hospital & Medical

JOB REQUIREMENTS: 7-10 Year Interior Designer - Healthcare Job Locations US-WI-Milwaukee Job ID 2025-3126 Category Interior Design Position Type Regular Full-Time # of Openings 1 Posted Date 2 hours ago(6/5/2025 4:33 PM)...

2d ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.