Medical Director - Medicaid Virginia - CVS : Job Details

Ready to take your Medical Director skills to the next level with a Fortune 6 company? Checkout this opportunity with Aetna, a CVS Health company! Aetna operates Medicaid Managed Care Plans in multiple states: Arizona, Florida, Illinois, Kentucky, Louisiana, Maryland, Michigan, New Jersey, New York, Ohio, Oklahoma, Pennsylvania, Texas, Virginia and West Virginia. This is a regional role that primarily supports Medicaid plans in Aetnas Northeast region but may support other plans when needed. This UM (Utilization Management) Medical Director will be a Work from Home position primarily supporting the Aetna Virginia Medicaid plan and the UM team. The UM Medical Director will ensure timely and consistent responses to members and providers related to precertification, concurrent review, and appeal request. This position is primarily responsible for Utilization Management, including prior authorization as well as concurrent review. Cases could focus on inpatient or outpatient services, ac...Medical Director, Director, Medical, Patient Care, Patient Services, Retail, Healthcare