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CVS HealthCore Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in clinical program development and implementation, with a strong focus on medical management and patient care. Holds an active medical license and board certification, ensuring compliance with healthcare standards and effective collaboration with providers.
Highest-signal resume keywords
Active Medical LicenseM.D. Or D.O.Board Certification In A Recognized SpecialtyClinical Practice ExperienceManaged Care Experience
About the role
Key responsibilities & impact- Participate in the development, implementation, and evaluation of clinical/medical programs
- Expand Aetna's medical management programs to address member needs across the continuum of care
- Support Medical Management staff in providing timely and consistent responses to members and providers
- Conduct or support Prior Authorization, Pre-Certification, Concurrent Reviews, Peer to Peer calls, First Level Appeals, special projects, and committee participation
- Provide clinical expertise and business direction through participation in clinical team activities
- Act as lead business and clinical liaison to network providers and facilities
- Support effective execution of medical services programs by clinical teams
Requirements
What you’ll need- 2 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 a recognized specialty
- Post-graduate direct patient care experience
- Five or more years of direct patient care experience (preferred)
- Electronic medical systems/record experience (preferred)
- Managed Care experience (preferred)
- Board certification in Internal Medicine, Family Medicine, Emergency Medicine, General Surgery, or other surgery specialties (preferred)
Benefits
Comp & perks- CVS Health bonus, commission or short-term incentive program
- Award target in the company’s equity award program
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Clinical Program DevelopmentPrior AuthorizationPre-CertificationConcurrent ReviewsPeer To Peer CallsFirst Level AppealsDirect Patient Care ExperienceElectronic Medical Systems Experience
Soft Skills
Effective CommunicationCollaboration
Certifications & Qualifications
Board Certification In Internal MedicineBoard Certification In Family MedicineBoard Certification In Emergency MedicineBoard Certification In General Surgery
Industry Keywords
Health Care Delivery SystemMedical Management ProgramsClinical ExpertiseNetwork ProvidersContinuum Of Care