Medical Director -Spine

Position Summary

We are Aetna, a CVS Health Company, seeking a Medical Director (Spine) to provide clinical expertise and oversee medical management programs related to orthopedic spine or neurosurgery. This full‑time, remote position offers competitive salary, benefits, and opportunities for professional growth.

Responsibilities

• Expand Aetnas medical management programs to address member needs across the continuum of care.
• Support Medical Management staff by ensuring timely and consistent responses to members and providers.
• Lead utilization review and quality assurance activities, directing case management processes.
• Provide clinical expertise and business direction in support of medical management programs through participation in clinical team activities.
• Serve as the primary business and clinical liaison to network providers and facilities to support the effective execution of medical services programs.
• Perform predetermination and claim determinations reviews, delivering 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 the health care industry.
• Active and current state medical license without encumbrances.
• M.D. or D.O., Board Certification in Orthopedic Spine or Neurosurgery with post‑graduate direct patient care experience.

Preferred Qualifications

• Previous healthcare insurance experience.

Pay Range

The typical pay range for this role is:

• $174,070.00 - $374,920.00

This 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 experience, education, geography, and other relevant factors. The role is eligible for a CVS Health bonus, commission or short‑term incentive program in addition to the base pay range and includes a target award in the company’s equity award program.

Benefits

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. Benefits include medical, dental, vision coverage, paid time off, retirement savings options, wellness programs, and other resources based on eligibility.

EEO Statement

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