Senior Medical Director Precertification Team

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.

Requirements

• MD or DO with active, unrestricted license and board certification in an ABMS or AOA recognized specialty
• Minimum 5 years of direct patient care in a clinical setting
• Minimum 5 years in utilization management, precertification, or related roles
• Deep expertise in Medicare regulations, including NCDs, LCDs, Medicare manuals, and regulatory references
• Proven ability to interpret and apply Medicare guidelines to complex case review and decision-making
• Advanced knowledge of medical coding standards, compliance requirements, and oversight of coding practices
• Demonstrated leadership in managing teams, driving process improvement, and ensuring regulatory compliance
• Successful track record guiding teams through Medicare audits and maintaining audit readiness
• Strong interpersonal, communication, and cross-functional stakeholder management skills
• Commitment to developing talent and fostering an inclusive, high-performing team culture

Benefits

• Affordable medical plan options
• 401(k) plan
• Employee stock purchase plan
• 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