Medical Director, Medicare Grievances
HumanaFull Time
Senior (5 to 8 years)
Key technologies and capabilities for this role
Common questions about this position
The typical pay range for this role is $174,070.00 - $374,920.00, with the actual base salary depending on factors like experience, education, geography, and other relevant factors.
Yes, this is a 'Work from Home' position primarily supporting the Aetna Illinois Medicaid plan, part of a centralized team for Illinois, Michigan, Kansas, and Oklahoma, with occasional support for other regions.
Required qualifications include five or more years of direct patient care experience, an active Illinois state medical license without encumbrances, M.D. or D.O. with current board certification in an ABMS or AOA specialty, and board certification in Family Medicine or Internal Medicine/Pediatrics.
This role is part of a centralized UM team supporting Illinois, Michigan, Kansas, and Oklahoma, primarily focused on the Aetna Better Health Plan of Illinois, with a rotating on-call schedule for weekends and holidays.
Strong candidates will have the required five years of direct patient care, Illinois medical license, M.D./D.O. with relevant board certifications, plus preferred experience in health plan/payor UM, managed care, and Medicaid.
Comprehensive pharmacy and healthcare services
CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.