Medical Director, Spine

The Medical Director (Spine) will be a Subject Matter Expert (SME) with a background in Orthopedic Spine OR Neurosurgery, including post-graduate direct patient care experience specifically.

Expands Aetna's medical management programs to address member needs across the continuum of care.

Supports the Medical Management staff ensuring timely and consistent responses to members and providers.

Leads all aspects of utilization review / quality assurance, directing case management Provides clinical expertise and business direction in support of medical management programs through participation in clinical team activities.

Acts as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams.

Responsible for predetermination reviews and reviews of claim determinations, providing clinical, coding, and reimbursement expertise, using multiple computer based applications.

This is a partial description of the position. The Medical Director Spine is a fully REMOTE, WORK FROM HOME position.

Please direct all inquiries to paul@caduceussearch.com or me phone direct at 402-850-7390.