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Outstanding opportunity for a Medical Director - Medical Affairs (Oncology). This remote role involves clinical oversight, consultative support, utilization management, and research responsibilities across the PBM and enterprise. The role calls for a skilled oncologist committed to reimagining health care.
Job Responsibility:
Provide clinical business support to the entire enterprise
Provide clinical oversight and mentorship for CVS Health clinical programs
Consultative support to the P&T process, formulary development, drug information services, and pipeline activities
Clinical leadership to internal departments and clients
Complete assigned medication utilization reviews (PA) and/or medical necessity appeals for clients
Participate in inter-rater review activities and other quality oversight processes
Perform special clinical investigations and research as requested
Share in reviews of utilization management criteria and clinical policy revisions/reviews
Support UM programs across various segments including commercial, Medicare, and Medicaid
Requirements:
Minimum of 5 years clinical experience in direct patient care
Board Certified in Hematology/Oncology
2 or more years proven experience in clinical outcomes, with a solid understanding of medical statistics, regulatory agencies, and analytic programs
Unrestricted license to practice medicine in the state in which the candidate is located
Nice to have:
Additional Board Certification in Internal Medicine
Master’s Degree in Public Health Administration, MBA, and/or UM/QA certification
Proficiency in MS Office Suite, including Teams and Outlook
What we offer:
Affordable medical plan options
401(k) plan including matching company contributions
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