Medical Director – Spine

Role Overview

• Be a Subject Matter Expert (SME) with a background in Orthopedic Spine OR Neurosurgery.
• Expand Aetna's medical management programs to address member needs.
• Support the Medical Management staff ensuring timely responses to members and providers.
• Lead all aspects of utilization review/quality assurance, directing case management.
• Provide clinical expertise and business direction in support of medical management programs.
• Act as lead business and clinical liaison to network providers to support medical services programs.
• Responsible for predetermination reviews and review of claim determinations.

Requirements

• 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 Orthopedic Spine OR Neurosurgery, including post-graduate direct patient care experience specifically.

Benefits

• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings
• Tobacco cessation and weight management programs
• Confidential counseling and financial coaching
• Paid time off
• Flexible work schedules
• Family leave
• Dependent care resources
• Colleague assistance programs
• Tuition assistance
• Retiree medical access