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Medical Director - Behavioral Health

May 26, 2026

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.The hours for this role are Monday through Friday from 8:00 am to 5:00 pm Pacific TimePosition SummaryAetna, a CVS Health Company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity to help transform health care. We believe that a better care system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources. In this role has Medical Director (Behavioral Health) you will:* Provide comprehensive behavioral health care management to facilitate delivery of appropriate quality care and improve program/operational efficiency involving clinical issues * Provide leadership and day-to-day physician oversight for utilization management team, including the management of high-risk cases and medical necessity decisions * Participate in the development, implementation, and evaluation of clinical/medical programs * Provide psychiatric leadership to an interdisciplinary utilization management team, including medical/clinical oversight, consultation and training * Provide day-to-day physician oversight including management of high-risk cases throughout treatment/levels of care and medical necessity decisions * Assist with the development, implementation, monitoring and evaluation of the utilization management program and action plan, ensuring quality and appropriateness of care * Assist with the development, implementation and interpretation of medical policy including medical necessity criteria, clinical practice guidelines and new technology assessments * Confer with behavioral health practitioners regarding the care of patients with severe, complex and/or treatment resistant illnesses * Identify and address quality of care concerns with providers involved in a member's care * Participate in the appeals process, including the investigation of adverse events and quality of care concerns * Provide psychiatric leadership for NCQA-compliant clinical quality improvement activities in collaboration with clinical and quality improvement staff * Participate in the triage and referral for care management*Weekend coverage up to 4 times/year. Required Qualifications * Board Certification in Psychiatry* Minimum 5 years of clinical practice experience in the health care delivery field as a psychiatrist.*Child/Adolescent Board Certification preferred*Hold current California medical license or be able to obtain California, Texas and Arizona license Preferred Qualifications * Experience with managed care, as a provider and manager of careutilization review or physician advisor experience. Education* Active and current state medical license without encumbrancesMD or DO.Pay RangeThe 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 peopleWe take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. 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, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on <a href="https://learn.bswift.com/cvshealth-mainland" target="_blank" rel="noopener noreferrer">Benefits Moments</a>. We anticipate the application window for this opening will close on: 06/12/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

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