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Medical Director - Medicaid Virginia

Medical Director - Medicaid Virginia

CVS HealthPuerto Rico, Work At Home, US
At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading h...Mostrar másÚltima actualización: hace 18 días
Promotion Assistant

Promotion Assistant

Spanish Broadcasting SystemPuerto Rico
As a pioneer in Spanish-language media, SBS has always been at the forefront of the evolution of Hispanic entertainment in the U. In this era of technological advancements and media convergence, SBS...Mostrar másÚltima actualización: hace 18 días
Stock Associate, Part-Time, Mall of San Juan, Pottery Barn

Stock Associate, Part-Time, Mall of San Juan, Pottery Barn

Pottery BarnPR, United States
Receive shipments & accurately maintain inventory records.Maintain stockroom & off-site locations.Assist sales team in replenishing sales floor after shipment or during recovery periods.You’re exci...Mostrar másÚltima actualización: hace más de 30 días
Sandwich Artist Job at Subway - 34337-0 in 00767

Sandwich Artist Job at Subway - 34337-0 in 00767

Mediabistro00767, PR, United States
As part of the Subway® Team, you as a Sandwich Artist ® will focus on four main things : .Providing an excellent Guest experience. Preparing and serving great food .Keeping restaurants clean and beaut...Mostrar másÚltima actualización: hace 24 días
Customs and Border Protection Officer

Customs and Border Protection Officer

U.S. Customs and Border ProtectionPR
Customs and Border Protection (CBP) offers those interested in a career in law enforcement an exceptional opportunity to work with an elite team of highly trained professionals whose camaraderie, p...Mostrar másÚltima actualización: hace 1 día
Warehouse Employee •2nd Shift

Warehouse Employee •2nd Shift

Cardinal HealthPuerto Rico, United States
Warehouse Operations is responsible for performing / controlling a combination of manual or automated tasks necessary for the receipt, storage, and shipment of product. This may include functions of r...Mostrar másÚltima actualización: hace 7 días
Subway - 19750-0 is hiring : Sandwich Artist in 00773

Subway - 19750-0 is hiring : Sandwich Artist in 00773

Subway - 19750-000773, PR, United States
As part of the Subway® Team, you as a Sandwich Artist ® will focus on four main things : .Providing an excellent Guest experience. Preparing and serving great food .Keeping restaurants clean and beaut...Mostrar másÚltima actualización: hace 24 días
Associate Optometrist – Walmart (Greater San Juan, PR)

Associate Optometrist – Walmart (Greater San Juan, PR)

Walmart WalmartPuerto Rico, US
Walmart is now hiring Associate Optometrists​ in Puerto Rico- including in Carolina, Fajardo, Hatillo, Humaco, Santurce, and Toa Baja!. This is a great opportunity for experienced doctors or new gra...Mostrar másÚltima actualización: hace 18 días
MORTGAGE SERVICING MANAGER - MORTGAGE - FIRSTBANK PR

MORTGAGE SERVICING MANAGER - MORTGAGE - FIRSTBANK PR

First BanCorpPuerto Rico
Our more than 3,100 employees in Puerto Rico, the Virgin Islands and Florida share a passion for excellent customer service. We are proud of our team because they are continuously surpassing our cli...Mostrar másÚltima actualización: hace 14 días
Sales Merchandiser (West Area)

Sales Merchandiser (West Area)

Cardinal Health International Philippines Inc.Territorywide, Puerto Rico
What Merchandising contributes to Cardinal Health.Responsible for providing technical and professional expertise related to retail independent store merchandising, including implementing merchandis...Mostrar másÚltima actualización: hace 5 días
Vans : Seasonal Sales Associate - Barceloneta

Vans : Seasonal Sales Associate - Barceloneta

VF CorporationPuerto Rico, US
Vans is the original brand rooted in the authentic lifestyle of skateboarding.We are driven by our mission to inspire and empower everyone to live “Off The Wall” – embracing the youthful spirit of ...Mostrar másÚltima actualización: hace 18 días
Electrical Engineers-Talent Bank

Electrical Engineers-Talent Bank

Share Tech GroupAll Puerto Rico, PR
Quick Apply
Share Tech Group is an architectural, engineering, project management, and environmental consulting services firm seeking to hire Electrical Engineers. We are seeking Engineers for vari...Mostrar másÚltima actualización: hace más de 30 días
EHS Coordinator (3107)

EHS Coordinator (3107)

CPMSouth, PR, Puerto Rico
We are looking for a proactive and detail-oriented EHS Coordinator to oversee all aspects of environmental, health, and safety compliance within our organization. The ideal candidate will have a str...Mostrar másÚltima actualización: hace 14 días
Research and Evaluation Officer, Forward Society Lab - University of Toronto

Research and Evaluation Officer, Forward Society Lab - University of Toronto

J-PALPuerto Rico
A research practice partnership seeks to hire a Research and Evaluation Officer to serve as liaison between a team of researchers at the University of Toronto Forward Society Lab and the Puerto Ric...Mostrar másÚltima actualización: hace más de 30 días
Service Center Technician

Service Center Technician

EVERTECPuerto Rico
Do you want to be part of #TeamEvertec and join the #GeneracionNaranja?.Be part of an environment where you can contribute with your creativity, knowledge, and skills. We are the #TechnologyofthePos...Mostrar másÚltima actualización: hace más de 30 días
LL01-052725 Reliability Engineer

LL01-052725 Reliability Engineer

Validation & Engineering Group00986, PR, US
Validation & Engineering Group, Inc.V&EG) is a leading services supplier who provides solutions for the Pharmaceutical, Biotechnology, Chemical, Food, and Medical Devices industries in the ...Mostrar másÚltima actualización: hace más de 30 días
IT Program Manager

IT Program Manager

ICFPuerto Rico
TheProgramManager (PM) is responsible for overall management of the project team.The PM is responsible forfacilitating the workflow of client deliverables and providing final oversight and quality ...Mostrar másÚltima actualización: hace 17 días
Online Work From Home

Online Work From Home

Online Consumer Panels AmericaPuerto Rico, US
Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contracts with national and international companies. We guarantee 15-25 hours per week with an hourly pay of bet...Mostrar másÚltima actualización: hace más de 30 días
Handyman - Area Oeste (Aguadilla, Mayagüez y Moca)

Handyman - Area Oeste (Aguadilla, Mayagüez y Moca)

Prime Janitorial ServicePR
Quick Apply
RESUMEN DEL PUESTO El técnico de servicios ambientales / ”Handyman” es responsable de mantener los edificios, áreas verdes, equipos limpios y ordenados y en funcionamiento.Real...Mostrar másÚltima actualización: hace más de 30 días
Overnight - Guest Service Representative

Overnight - Guest Service Representative

SP Plus Corporation(M) SHERATON PUERTO RICO CONVENTION CTR, 62241
SP+, a Metropolis company, is an artificial intelligence company for the real world.We use computer vision to enable checkout-free parking experiences. So there’s no fumbling with tickets, machines,...Mostrar másÚltima actualización: hace 13 días
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Medical Director - Medicaid Virginia

Medical Director - Medicaid Virginia

CVS HealthPuerto Rico, Work At Home, US
Hace 18 días
Descripción del trabajo

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary :

Ready to take your Medical Director skills to the next level with a Fortune 6 company? Checkout this opportunity with Aetna, a CVS Health company!

Aetna operates Medicaid Managed Care Plans in multiple states : Arizona, Florida, Illinois, Kentucky, Louisiana, Maryland, Michigan, New Jersey, New York, Ohio, Oklahoma, Pennsylvania, Texas, Virginia and West Virginia.

This is a regional role that primarily supports Medicaid plans in Aetna’s Northeast region but may support other plans when needed. This UM (Utilization Management) Medical Director will be a "Work from Home" position primarily supporting the Aetna Virginia Medicaid plan and the UM team.

The UM Medical Director will ensure timely and consistent responses to members and providers related to precertification, concurrent review, and appeal request.

This position is primarily responsible for Utilization Management, including prior authorization as well as concurrent review. Cases could focus on inpatient or outpatient services, acute and post-acute services, pharmacy, appeals and state fair hearings. You will be part of a rotating on call schedule for providing weekend and holiday coverage.

Required Qualifications :

  • Five or more years of experience providing direct patient care.
  • Active state medical license without encumbrances and the willingness to get licensure in other states as needed.
  • M.D. or D.O., Current and Active Board Certification in ABMS or AOA recognized specialty, including post-graduate direct patient care experience
  • Board certification in Emergency Medicine, Family Medicine (with hospitalist experience), General Surgery or Internal Medicine preferred.

Preferred Qualifications :

  • Physician leadership
  • 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.

    Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

    Great benefits for great people

    We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include :

    Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan .

    No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

    Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

    For more information, visit

    We anticipate the application window for this opening will close on : 07 / 18 / 2025

    Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.