Role Description Aetna, a CVS Health company, has an outstanding opportunity for a Medical Director. This is a remote Work at Home position and can be located anywhere in the United States. In this role as Medical Director MPO (Medical Policy & Operations), you will be responsible for providing clinical expertise to promote the delivery of high quality, constituent focused medical care with a focus on clinical and payment policy. The Primary Responsibilities of this Medical Director role include: - Transactional reviews in support of the appeal process. - Clinical claim review process. - Predetermination of covered benefits in the Commercial and Medicare environments. - Participate on work groups as a clinical subject matter expert to identify and promote opportunities to improve the quality and efficiency of health care services. - Apply clinical coding and reimbursement expertise to ensure alignment and correct application of Aetna policies and practices to service and payment requests. - Proactively use data analysis to identify opportunities for quality improvement and positively influence the effective delivery of quality care services. - Be a subject matter expert, internal consultant and payment policy contributor. - Demonstrate the ability to work within and lead as necessary teams comprised of a diverse group of health delivery professionals in order to manage the business objectives of the company. - Work collaboratively with the functional areas. Qualifications - Five (5) 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 an ABMS recognized specialty including post-graduate direct patient care experience. Requirements - Health plan/payor experience. - Foundational baseline skills in Medicine, Health Policy, Coding: HCPCS / CPT, Clinical Policy, Reimbursement and Health Care Systems. - Strong communication skills both written and verbal. Education - M.D. or D.O. Pay Range The typical pay range for this role is: $174,070.00 - $374,920.00. This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program. Benefits This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include: - Medical, dental, and vision coverage. - Paid time off. - Retirement savings options. - Wellness programs. - Other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. Application Information We anticipate the application window for this opening will close on: 06/05/2026. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Title: Medical Director - Addiction Medicine Location: Raleigh United States Job Description: Outpatient MAT Opioid Treatment Program (OTP) Join our team at Raleigh Comprehensive Treatment Center (CTC) as a Medical Director, where you'll play a pivotal role in transforming lives through exceptional care. As a leader in medication-assisted treatment (MAT) and behavioral health services, CTC provides a supportive and collaborative environment dedicated to fostering recovery and wellness. In this role, you'll oversee medical and clinical practices, guide quality assurance, and provide direct patient care, all while working alongside a multidisciplinary team to uphold the highest standards of care. If you're a compassionate physician with a commitment to excellence and a passion for behavioral health and substance use treatment, we invite you to lead and inspire at CTC. Our Team: Raleigh Comprehensive Treatment Center (CTC), located in Raleigh, NC is part of Acadia Healthcare's Comprehensive Treatment Centers, the leading provider of medication-assisted treatment in the nation. Our team provides compassionate, high-quality counseling, therapy, medication, and guidance to patients seeking recovery from Opioid Use Disorder. - Age Group/Range: Adults - Practice Setting/Type: Outpatient OTP - Part-Time Schedule: Remote - Monday 5:30-12:00, Thursday 5:30-10:30 On-site - Tuesday 7:30-1:45, Wednesday 7:00-12:00 Role as Medical Director: The Medical Director is responsible for leadership, quality assurance, oversight and overall medical management of the clinic within the boundaries of state and federal regulations and accreditation standards. Responsibilities include planning, organizing medical and clinical practices; providing direct patient care and assisting other departments with direct interactions with physicians or medical staff. Role Responsibilities: - Oversees and is responsible for the quality, efficiency and management of delivering medical services within the clinic; - Defines protocols and assists in decision making pertaining to the medical care of patients that is consistent with current medical practice and CTC policies and procedures; - Provides oversight to other professional medical staff, as well as administrative or support staff, as designated; - Serves as a liaison between the medical staff, other clinic staff, division or corporate staff, and organizational leadership; - Monitors assigned staff to adherence to established medical and clinic policy; - Provides back up call coverage; - Serves in a teaching capacity for the training and development of other personnel; - Responsible for securing physical exam and history from the patient, reviewing medical records, making medical evaluations, request appropriate diagnostic testing, prescribes medications and treatments, assists in the management of behavioral or mental health problems of patients, maintains current medical records in accordance with federal or state regulation, and clinic or corporate policies and procedures; and, - Performs other duties as assigned. - Encourages and builds mutual trust, respect and cooperation among team members. Education & Experience Requirements: - Doctoral degree in Medicine (MD or DO) - Prefer previous experience in behavioral health or substance use (SUD) treatment - No history of alcohol or drug misuse for a period of three years before employment Licenses/Designations/Certifications: - Current license to practice medicine by the state in which the facility or clinic(s) operates - Board certification or certificate of admissibility for board certification by American Society of Addiction Medicine (ASAM), American Academy of Addiction Psychiatry (AAAP), or other certification within their discipline - Current DEA credentials to prescribe controlled substances without restrictions and per regulation within the state in which the practitioner will be working - Additional specific DEA credentials may be required, per state and clinic regulations or policy Our Comprehensive Treatment Network ~23,500 Employees · ~11,400 Beds · 258 Locations · 38 States · 1 Network As a leading provider of behavioral healthcare services in the United States and Puerto Rico, Acadia Healthcare operates 258 treatment facilities across 38 states. Our network of treatment facilities offers multiple levels of care for various behavioral health and substance use disorders. At Acadia, our primary goal is to meet patients where they're at in their treatment process. We do this by providing a multitude of levels of care, including detoxification, residential treatment for addiction, residential treatment for dual diagnosis, acute psychiatric inpatient hospitalization, medication-assisted treatment (MAT) services, and an array of outpatient programming options, ranging from partial hospitalization programs (PHPs) and intensive outpatient programs (IOPs) to traditional outpatient services. Our expansive network of treatment facilities creates greater access to care, reduces the stigma associated with mental illness and addiction, and offers those in our communities a safe environment in which to receive the treatment they need. We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws. #LI-CTC

• Responsible for becoming familiar with the standards of practice for assisted living • Achieving a proficient level of competency within all departments of the Community. • Assisting in the overall operation of the Community while completing the required training hours for certification or licensure.

Requisition Number: 2286240 Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Medical Director Oncology will provide utilization review determinations and support case and disease management teams to achieve optimal clinical outcomes. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Perform utilization review determinations for oncology populations, and support case and disease management teams to achieve optimal clinical outcomes - Serve as a subject matter expert in evidence - based oncology guidelines, especially those produced by the National Comprehensive Cancer Network (NCCN), and help ensure all clinically relevant policies and processes are informed by the best available evidence - Engage and collaborate with treating providers telephonically; This will include discussion of evidence-based guidelines, opportunities to close clinical quality / service gaps, and care plan changes that can impact health care expense - Enhance clinical expertise of the Oncology team through education sessions with nursing teams, and serving as a thought leader and point of contact for relevant medical societies and stakeholders - Evaluate clinical and other data (e.g., quality metrics, claims and health record data, utilization data) to identify opportunities for improvement of clinical care and processes - Collaborate with operational and business partners on enterprise-wide research and clinical and quality initiatives to enhance Optum impact in the oncology field You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: - MD or DO with an active, unrestricted medical license - Obtain additional licenses as needed - Current Board Certification in an ABMS or AOBMS specialty in Oncology - 5+ years of clinical practice experience (inclusive of Medical Oncology) - Experience working with NCCN guidelines - Demonstrated accomplishments in the areas of medical care delivery systems, utilization management, case management, disease management, quality management, product development, and/or peer review - Participate in rotational holiday and call coverage Preferred Qualification: - Experience in managed care and quality management *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy The salary range for this role is $238,000 to $357,500 annually based on full-time employment. Salary Range is defined as total cash compensation at target. The actual range and pay mix of base and bonus is variable based upon experience and metric achievement. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.