Medical Director - Commercial
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do.
Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. This is a full-time, remote position that can be based anywhere within the United States. Position Summary Aetna, a CVS Health 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
In This Role You Will
- You will 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.
- You will support the Medical Management staff ensuring timely and consistent responses to members and providers.
- This includes Prior Authorization/Pre-Certification/Concurrent Reviews/Peer to Peer calls/First Level Appeals/Special Projects and Committee participation when needed.
- You will 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.
- 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 recognized specialty including post-graduate direct patient care experience.
- Preferred Qualifications: *Five or more years of direct patient care experience *Electronic medical systems/record experience *Managed Care experience *Board certification in Internal Medicine, Family Medicine, Emergency Medicine
- General Surgery or other surgery specialties.
- Education *Active and current state medical license without encumbrances *M.D. or D.O., Board Certification in a recognized specialty including post-graduate direct patient care experience 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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
- 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.
- The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
- Additional details about available benefits are provided during the application process and on Benefits Moments .
- We anticipate the application window for this opening will close on: 08/14/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.