CVS Health
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) 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 expands Aetna's medical management programs to address member needs across the continuum of care. Supports the Medical Management staff in ensuring timely and consistent responses to members and providers. Leads all aspects of utilization review / quality assurance, directs case management, and provides clinical expertise and business direction in support of medical management programs through participation in clinical team activities. Acts as the 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 claims 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. Pay Range:
$174,070.00 - $374,920.00 This pay range represents the base salary or hourly rate for positions within this job grade. The actual offer will depend on experience, education, geography, and other factors. The role is eligible for bonuses, commissions, or short-term incentives, and includes an equity award target. Our people fuel our future. We are committed to fostering a workplace where every colleague feels valued and belongs. Benefits
Our comprehensive benefits include medical plans, 401(k) with matching, stock purchase plans, wellness programs, counseling, financial coaching, paid time off, flexible schedules, family leave, dependent care resources, tuition assistance, retiree medical access, and more. Application Info
Application deadline: 07/18/2025. Qualified applicants with arrest or conviction records will be considered in accordance with applicable laws.
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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 expands Aetna's medical management programs to address member needs across the continuum of care. Supports the Medical Management staff in ensuring timely and consistent responses to members and providers. Leads all aspects of utilization review / quality assurance, directs case management, and provides clinical expertise and business direction in support of medical management programs through participation in clinical team activities. Acts as the 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 claims 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. Pay Range:
$174,070.00 - $374,920.00 This pay range represents the base salary or hourly rate for positions within this job grade. The actual offer will depend on experience, education, geography, and other factors. The role is eligible for bonuses, commissions, or short-term incentives, and includes an equity award target. Our people fuel our future. We are committed to fostering a workplace where every colleague feels valued and belongs. Benefits
Our comprehensive benefits include medical plans, 401(k) with matching, stock purchase plans, wellness programs, counseling, financial coaching, paid time off, flexible schedules, family leave, dependent care resources, tuition assistance, retiree medical access, and more. Application Info
Application deadline: 07/18/2025. Qualified applicants with arrest or conviction records will be considered in accordance with applicable laws.
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