Lead Director – Clinical Innovation, Analytics Delivery

Job not on LinkedIn

🔥 4 hours ago

🦌 Connecticut – Remote

🦌 Connecticut – Remote

💵 $100k - $231.5k / year

⏰ Full Time

🟠 Senior

👨‍⚕️ Medical Director

👻 Ghost score 0%

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CVS Health Careers

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛒 Retail

📦 Logistics

Healthcare • Retail • Logistics

CVS Health Careers is the recruitment and employer branding arm of CVS Health, showcasing job opportunities across the company's broad operations—pharmacy retail stores, pharmacy services, health care clinics, distribution warehouses, corporate functions and transportation. The careers site emphasizes purpose-driven work focused on improving access, affordability and quality of health care, and highlights a large workforce (300,000+ employees), inclusive culture, benefits, and hiring resources for applicants.

📋 Description

• Evaluate Utilization Management performance, market trends, regulatory developments, and emerging technologies • Lead strategic analyses, business cases, and investment recommendations • Drive strategic portfolio planning for UM modernization initiatives, including opportunity assessment, prioritization, resource alignment, funding recommendations, and value realization tracking • Partner with Clinical Operations, Product, Technology, and Enterprise Innovation teams to execute a multi-year UM modernization roadmap • Identify, evaluate, and implement automation opportunities using AI, Generative AI, predictive analytics, NLP, business rules engines, and decision support technologies • Develop and monitor KPIs, dashboards, and performance measurement frameworks • Provide strategic oversight and governance for innovation pilots, proof-of-value assessments, and transformation initiatives • Advise senior leaders on UM strategy, operational performance, automation opportunities, and enterprise transformation priorities • Manage and develop a high-performing team through coaching, mentoring, and professional development

🎯 Requirements

• 10+ years of experience leading strategic planning, business analysis, consulting, portfolio management, transformation, or innovation initiatives within healthcare, health insurance, or managed care organizations • Deep understanding of health plan operations including Utilization Management, Policy Management, Care Management, Quality, Compliance, Regulatory Management, Claims, and Provider Networks • Demonstrated experience developing and leading enterprise strategic initiatives from concept through implementation and value realization • Strong analytical and problem-solving skills, including business modeling, financial analysis, data synthesis, and development of executive-level recommendations • Proven success in enterprise portfolio management, strategic planning, and prioritization of complex initiatives • Experience with data visualization tools and advanced analytics technologies, including SQL, Python, and cloud-based data platforms • Strong understanding of automation, AI-enabled workflows, digital transformation, and technology-driven operational improvement • Expertise in developing business cases, defining success metrics, and measuring return on investment for strategic initiatives • Strong interpersonal and communication skills with the ability to effectively influence senior leaders and key stakeholders • Bachelor's Degree or equivalent work experience • AHIP certifications preferred

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to base pay • 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

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