Medical Director in United States

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. Position Summary: Ready to take your Medical Director career to the next level with a Fortune 6 company? Join Aetna, a CVS Health company, and make a meaningful impact on the health and well-being of Medicaid members across the country. Aetna operates Medicaid managed care plans in Arizona, Florida, Illinois, Kentucky, Louisiana, Maryland, Michigan, New Jersey, New York, Ohio, Oklahoma, Pennsylvania, Texas, Virginia, and West Virginia. We are seeking a Medical Director to join our centralized Medical Management team. This work-from-home position will primarily support Aetna Better Health of Louisiana , while also providing support across the other health plans as needed. In this role, you will partner with Medical Management staff to ensure timely, consistent, and clinically sound decisions for members and providers. Key responsibilities include: Utilization Management and medical necessity reviews Prior authorization and precertification determinations Concurrent review for inpatient and outpatient services Acute and post-acute care reviews Peer-to-peer consultations with treating providers Pharmacy reviews and first-level appeal determinations Collaboration with multidisciplinary clinical and operational teams The Medical Director also participates in a rotating on-c

Become a part of our caring community The Medical Director, National Outpatient Medicare leverages clinical expertise and medical judgment to review preauthorization requests for services. This role is responsible for evaluating moderately complex to complex cases, where analysis of clinical information and situational factors requires in-depth assessment and sound decision-making. As a Medical Director at Humana , you will use your clinical expertise and judgment to make meaningful coverage and care determinations that support quality, consistency, and compliance across the healthcare continuum. In this role, you will review requests for services, level of care, and site of service, using nationally recognized clinical guidelines, CMS policies, medical references, and internal clinical resources to guide decision-making. This position offers the opportunity to work on complex outpatient cases , review clinical documentation, and collaborate with both internal partners and external physicians to gather additional information and discuss determinations. You may also contribute to care management activities and, depending on the role, provide input on areas such as clinical documentation, coding, grievances and appeals, and outpatient services or equipment reviews. Beyond case review, this role provides the opportunity to build strong relationships with physicians, provider groups, facilities, and community partners in support of regional priorities. It is a strong fit for physicians who are interested in contributing to value-based care, population health, and care management strategies while working in a structured environment that values sound clinical judgment, collaboration, and operational excellence. Humana is seeking a Medical Director to

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. Job Purpose and Summary: Join a mission-driven organization at a transformative moment in employer-sponsored health care. As Executive Medical Director, Clinical Business Solutions at Aetna, a CVS Health company, you will lead the clinical team that serves as the clinical voice to our Commercial plan sponsors, prospects, and their advisors, demonstrating how Aetna’s clinical capabilities reduce cost, improve population health, and strengthen the member and provider experience. Reporting directly to the Vice President, Chief Medical Officer, Commercial & Innovation, you will direct a national team of clinicians (MD, RN, NP) providing clinical support to Aetna’s National Accounts, Large Group, and Public & Labor businesses, in close partnership with Field and Account teams. You will lead and continuously improve the operations of the team to raise the level and quality of clinical support delivered to the Field, while sharing directly in its external work — including personally cultivating and holding relationships with key brokers, consultants, and plan sponsors. The role is deliberately bidirectional. You will bring the voice of the customer and the producer community back into the organization, partnering with Clinical Operations, Medical Affairs, Commercial Product, and others to ensure our clinical offerings reflect what the market requires. <p

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. Senior Medical Director, Clinical Informatics Position Summary The Senior Medical Director for Clinical Informatics and Healthcare Delivery (HCD) Technology Product serves as the senior physician leader across healthcare delivery technical domains, providing clinical insight and technical expertise to drive end-to-end technology execution and ensure that Epic-enabled solutions advance core business outcomes. This role is the clinical expert and trusted physician advisor for teams across HCD technology, driving effective enterprise governance, improving clinician experience, enhancing patient outcomes, and supporting organizational strategic priorities. The Senior Medical Director will also serve as the product leader for two core HCD technology domains - Center Operations and Quality/Stars. The Senior Medical Director brings hands-on clinical and Epic build expertise, partners closely with operational and technical leadership across the enterprise to align the Epic roadmap with organizational strategy, has excellent clinical judgement and keeps patient experience, safety, and outcomes at the center of everything we do, and represents the clinical voice in enterprise governance, escalation, and innovation efforts. Key Responsibilities Clinical Product & Technology Leadership Serve as the senior product leader across Clinic Operations and Quality

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. The purpose of the Center Medical Director role is to lead the clinical team at their center in providing the best patient care and a great place to work in order to keep patients happy, healthy and out of the hospital. The Medical Director will practice primary care in our clinics alongside their provider colleagues at 80% clinical time and 20% administrative time. The CMD will have mission-critical leadership responsibilities, which include setting an example for how thoughtful primary care is practiced, serving as a formal mentor, coach, and advisor to providers in clinics, and participating in critical organizational-wide strategic initiatives. Core Responsibilities: The Center Medical Director is the medical leader for his/her center. In this role the CMD will have the following responsibilities: Support of Organizational Strategy Work in tight collaboration with the Practice Manager and Outreach Manager/Director to achieve our organizational objectives: Best Care Anywhere Unmatched Patient Experience Exceptional Growth Great Place to Work and Leader in DE&I Drive implementation of strategic initiatives. Follow direction from regional leadership (regional medical director or senior medical director) in collaboration with CMDs in the region to implement regional priorities and reach regional objectives.<br

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. Title: Center Medical Director Company: Oak Street Health Role Description: The purpose of the Center Medical Director role at Oak Street Health is to lead the clinical team at their center in providing the best patient care and a great place to work in order to keep patients happy, healthy and out of the hospital. The Medical Director will practice primary care in our clinics alongside their provider colleagues at 80% clinical time and 20% administrative time. The CMD will have mission-critical leadership responsibilities, which include setting an example for how thoughtful primary care is practiced, serving as a formal mentor, coach, and advisor to providers in Oak Street clinics, and participating in critical organizational-wide strategic initiatives. Core Responsibilities: The Center Medical Director is the medical leader for his/her OSH center. In this role the CMD will have the following responsibilities: Support of Organizational Strategy Work in tight collaboration with the Practice Manager and Outreach Manager/Director to achieve our organizational objectives: Best Care Anywhere Unmatched Patient Experience Exceptional Growth Great Place to Work and Leader in DE&I Drive implementation of OSH strategic initiatives. Follow direction

ROLE SUMMARY The Clinician Medical Monitor is accountable for providing medical and scientific expertise and oversight for Clinical Trials and serves as a single point of accountability for design, execution, monitoring, delivery and reporting of one or more clinical studies and to ensure patient safety. The clinician medical monitor may be required to design a development strategy for multiple protocols designed to obtain worldwide approval for a compound or group of compounds. In addition to study level activities, the clinician medical monitor may participate in standing committees, review compounds for potential in-licensing, including performance of due diligence reviews, and aid new business development on market opportunities and the target product profile. ROLE RESPONSIBILITIES Accountable for safety across the study Provide study team with medical advice for all medical issues during risk assessment and mitigation planning to enable quality, compliance and patient safety at the trial, site and patient level. Ensures development of and adherence to the Safety Surveillance Review Plan (SSRP). Consistent with the SSRP, performs and documents regular review of individual subject safety data, and performs review of cumulative safety data with the safety risk lead. As appropriate, the clinician medical monitor may delegate these responsibilities to the study clinician scientist identified in the SSRP. The specific components of safety data review are detailed in the appropriate SOPs and the “Safety Data Review Guide – for Clinicians.” Monitor study safety issues and provide input to serious adverse events (SAEs) reports. Provides appropriate medical context in terms of risk factors, medical history and other important medical factors required to put the SAE or AE into appropriate medical context required for benefit-risk assessm

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. Title: Primary Care Physician Company: Oak Street Health Address: 436 E Washington Blvd, Fort Wayne, IN 46802 Salary: $240,000- $270,000 **Wider range available depending on experience and location Schedule: Full-Time, Monday through Friday, 8:00 AM - 5:00 PM Role Description: The purpose of a Primary Care Physician at Oak Street Health is to provide equitable and effective value-based healthcare to local Medicare patient populations at our innovative network of neighborhood primary care centers. Our Primary Care Physicians operate at a single medical center supported by large care teams so our providers can focus on delivering a better quality of care, rather than a volume of services. Our value-based care model and competitive bonuses are structured to reward outcomes, drive low hospital admissions, deliver preventive medicine, and result in an unmatched patient experience. We’re looking for physicians who are intrinsically motivated to provide this kind of excellent care to older adults. New graduates are encouraged to apply. Highly qualified candidates may also be considered for a Center Medical Director position. Responsibilities: Assess and diagnose patients at our local clinics Oversee, direc

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. Title: Primary Care Physician Company: Oak Street Health Location: 951 N 6th St #221, Reading, PA 19601 Salary: $240,000 - $270,000 *Wider range available depending on experience and location Role Description: The purpose of a Primary Care Physician at Oak Street Health is to provide equitable and effective value-based healthcare to local Medicare patient populations at our innovative network of neighborhood primary care centers. Our Primary Care Physicians operate at a single medical center supported by large care teams so our providers can focus on delivering a better quality of care, rather than a volume of services. Our value-based care model and competitive bonuses are structured to reward outcomes, drive low hospital admissions, deliver preventive medicine, and result in an unmatched patient experience. We’re looking for physicians who are intrinsically motivated to provide this kind of excellent care to older adults. New graduates are encouraged to apply. Highly qualified candidates may also be considered for a Center Medical Director position. Responsibilities: Assess and diagnose patients at our local clinics Oversee, direct, and administer

Become a part of our caring community Provides executive leadership to Humana. The Regional Chief Medical Officer (CMO) is an entrepreneurial & experienced physician leader committed to the principles of comprehensive primary care and unlocking the power of value-based care for patients at national scale. S/he will be a proven clinician, leader, and strategist capable of driving the highest standards of care, building high-performance care teams, developing clinical leadership talent, and quantifiably improving outcomes and performance across multiple geographies. The Regional CMO will directly lead a team of regional & area medical directors and serve as dyad partner to the Regional Market President for one of the Primary Care Organization’s regions across the nation where CenterWell and/or Conviva serve patients. The Regional CMO will report to the Chief Medical Officer of the Primary Care Organization. This role requires periodic travel to markets (40% or less) to meet with national and regional teams and should be based in one of our current or upcoming CenterWell or Conviva markets. Responsibilities Drive Clinical Excellence in Culture & Performance · Build a best-in-class culture of engaged clinicians, focused on patient-focused care and clinical excellence, where doing the right thing for patients and team-based care within a value-based care framework, drives success and pride · Drive patient outcomes and population impact across regions for optimal results, across patient care experience & engagement, disease prevalence, quality/STARS, efficiency of care, and improved clinical outcomes and utilization. · Identify and act on opportunities

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 122,000 colleagues serve people in more than 160 countries. JOB DESCRIPTION: Job Description Position Overview The Clinical Laboratory Scientist I performs laboratory analysis on clinical specimens using established laboratory procedures within the assigned department/laboratory. The Clinical Laboratory Scientist I duties will include, but are not limited to, processing of specimens, performance of moderate and highly complex analytical testing, establishing, performing, and documenting quality assurance, quality control, equipment maintenance, and accurately documenting all work performed under the direction of the Laboratory Medical Director. As a Clinical Laboratory Scientist I, you will recognize and resolve problems using good laboratory practices. Shift: Sat - Mon, 6p - 630a Essential Duties (include but are not limited): Perform moderate and highly complex laboratory tests, procedures, and analyses according to the laboratory’s standard operating procedures. Perform, review, and document laboratory quality control procedures. Operate, maintain, and troubleshoot laboratory equipment. Prepare reagents required for laboratory testing. Identify and troubleshoot basic problems that adversely affect test performance and/or laboratory operations. Achieve and maintain competency on laboratory tasks. Assist with mentoring new laboratory personnel on current and new procedures, as needed. </

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. Position Summary The Waste & Error Certified Coding Manager is responsible for leading the Certified Coding Analyst and W&E Team Lead roles that conduct medical claim reviews and coding audits to identify billing errors, waste, abuse, fraud, and payment integrity opportunities. The Manager provides direct people leadership, establishes operational priorities, ensures consistent application of coding and billing requirements, and is accountable for team productivity, quality, service levels, compliance, and employee development. This role partners closely with the W&E team lead, who provides day-to-day technical guidance and subject matter support to the coding team. The Manager retains accountability for staffing, performance management, workload oversight, escalations, audit readiness, process improvement, and delivery of business outcomes. The position also represents the team in discussions with senior leadership, Medical Directors, Legal, Compliance, Analytics, Operations, and other Payment Integrity partners. Primary Responsibilities People Leadership & Team Development Lead, coach, and develop a team of Certified Coding Analysts and Senior Certified Coding Analysts. Establish clear role expectations, performance goals, productivity standards, quality requirements, and accountability measures. Conduct regular perfor

Work Flexibility: Field-based Emergency Care (Fire/EMS) Sales Representative As a Sales Representative at Stryker, you will be at the forefront of promoting and selling our Emergency Care products, with a focus on Fire Emergency Medical Services solutions, to pre-hospital providers. You’ll work with a diverse range of products, including Emergency Patient Transport, Defibrillators, Automated External Defibrillators (AED), and Chest Compression systems. This role will involve building and maintaining strong customer relationships, addressing inquiries, negotiating pricing, and managing orders seamlessly. By staying informed on industry trends, competitor activity, and regulatory shifts, you’ll position Stryker’s products effectively in the marketplace. You’ll also have the opportunity to exceed sales targets, monitor your performance, and collaborate with marketing and support teams to drive business growth and success. What you will do Continue experience in sales or clinical setting. Promote and sell Stryker Emergency Care products to meet our customers’ needs. Achieve your assigned quota by taking a consultative approach to Pre-Hospital sales, marketing, clinical and demonstrations of all related Fire/Emergency Medical Services products and programs. Become the resident Emergency Care expert as you work with a sophisticated audience of fire chiefs, medical directors, clinical instructors and administrators. Your knowledge not only of your own products, but of competitors’ offerings, builds credibility with your customers. <span style="f

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. Position Summary This position is open to candidates located in Arizona. The work schedule is Monday through Friday, from 8:30 AM to 5:00 PM Arizona time. The Care Management Associate (CMA) supports comprehensive coordination of medical services that include intake and outgoing calls for medical services. We work closely with both case management team and utilization management team. The Care Management Associate will review eligibility and benefits and open pre-certification cases and either approve or send to nursing staff for review. Additional responsibilities include but not limited to the following: - Evaluates patients using targeted intervention business rules and processes to identify needed medical services, make appropriate referrals to medical services staff, and coordinate the required services by the benefit plan. - Communicates health care service delivery as required based on outcomes/reviews noted by the nurse or medical director - Performs non-medical research pertinent to the establishment, maintenance, and closure of open cases. - Provides support services to team members by answering telephone calls from providers and members, taking accurate messages, supporting electronic transmission review and referrals as appropria

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. Utilization Management Nurse Consultant (RN) – Concurrent Review Remote | Acute Inpatient Utilization Management | RN Opportunity Are you an experienced RN with a background in acute care and utilization management? Join our team and play a vital role in ensuring members receive appropriate, high-quality, and cost-effective inpatient care through concurrent review and care coordination. What You'll Do Perform concurrent reviews for acute inpatient admissions and continued hospital stays Evaluate medical necessity, severity of illness, intensity of service, and level of care using evidence-based clinical criteria Collaborate with hospitals, physicians, care managers, and discharge planners to support appropriate treatment and timely transitions of care Review clinical documentation and apply health plan benefits and regulatory requirements to authorization decisions Partner with Medical Directors on complex cases and escalations Facilitate discharge planning and identify opportunities to optimize care and resource utilization Manage a high-volume caseload while meeting quality, productivity, and turnaround-time standards WHAT YOU BRING - REQUIRED Active, unrestricted RN license in your state of residence Ability to obtain and maintain additional state licensure as required 5&#43