Aetna Inc.

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Medical Director

at Aetna Inc.

Posted: 10/11/2019
Job Reference #: 68644

Job Description

Job Description
Provide oversight for medical policy implementation. Participate in the development, implementation, and evaluation of clinical/medical programs.

Req#
64202BR

Job Group
Healthcare

Full or Part Time
Full Time

Supervisory Responsibilities
No

Percent of Travel Required
0 - 10%

Posting Job Title
Medical Director

Additional Locations
FL-Plantation

Primary Location (City, State)
FL-Plantation

EEO Statement
Aetna is an Equal Opportunity, Affirmative Action Employer

Resource Group
5

Fundamental Components
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. Oversees 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

Background Experience
2-3 years of experience in Health Care Delivery System e.g., Clinical Practice and Health Care Industry. Active and current state medical license without encumbrancesM.D. or D.O., Board Certification in a recognized specialty including post-graduate direct patient care experience.

Benefits Program
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Candidate Privacy Information
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.