Executive Medical Director, Clinical Business Solutions

Job not on LinkedIn

🔥 1 minute ago

🦌 Connecticut – Remote

🦌 Connecticut – Remote

💵 $227.6k - $490.3k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Lead, coach, and develop a national team of clinicians across National Accounts, Large Group, and Public & Labor segments • Cultivate relationships with brokers, consultants, and plan sponsors • Lead clinical sales activities for high-profile prospects • Improve team operations, coverage, prioritization, preparation, and materials • Define the team coverage model and allocate clinical capacity based on pipeline value, retention risk, and strategic importance • Set standards for clinical narratives, presentation materials, and meeting preparation • Own hiring, onboarding, performance management, development planning, and succession • Serve as senior clinical leader for finalist meetings, RFP responses, and clinical strategy sessions • Develop strategic clinical messaging and articulate Aetna’s clinical differentiation • Keep Field teams current on Aetna’s clinical programs through briefings and training • Translate Aetna’s clinical program portfolio into prospect-specific value narratives • Support retention and growth through strategic client reviews, clinical roadmaps, and outcomes and affordability discussions • Interpret client-specific utilization, cost, and quality data and recommend clinical program actions • Own producer engagement with benefits consulting firms, brokers, and general agents • Lead clinical responses to consultant surveys, market scans, and program and vendor assessments • Represent Aetna at consultant forums, market events, industry conferences, and employer coalitions • Capture and channel customer, producer, and Field feedback into product and clinical roadmaps • Surface competitive gaps and emerging plan sponsor requirements • Maintain command of Commercial market dynamics, competitor strategy, health policy, and clinical program landscapes • Represent Commercial Medical Affairs in governance forums and cross-functional working groups • Ensure externally presented clinical claims are evidence-based, accurate, and defensible

🎯 Requirements

• MD (Doctor of Medicine) or DO (Doctor of Osteopathic Medicine) • Active and current medical license (MD or DO) without encumbrances in at least one U.S. state • Minimum 8 years of post-training experience in Commercial health insurance, managed care, benefits consulting, or a medical management organization • Demonstrated experience in an externally facing, client-facing capacity • Deep working knowledge of employer-sponsored Commercial health insurance, including funding arrangements, benefit design, utilization management, care management, network, and pharmacy integration • Ability to translate clinical and claims data into a clear business narrative for non-clinical executive audiences • Exceptional executive presence and platform skills • Ability to establish credibility and build durable relationships with sophisticated external buyers and intermediaries • Experience leading, coaching, or formally mentoring clinical colleagues • Exceptional stakeholder management skills and ability to build coalitions across diverse, matrixed internal audiences • Ability to travel approximately 25–50% for client, producer, and Field meetings • Preferred: Established relationships within the national benefits consulting and broker community, or with large self-insured employers • Preferred: Prior formal responsibility for named consultant, broker, or general agent relationships • Preferred: Direct people-leadership experience over a clinical team • Preferred: Experience across National Accounts, Large Group, and/or Public & Labor segments • Preferred: Externally facing experience at a national health plan, benefits consultancy, health services company, point solution marketing to employer groups, or large self-insured employer • Preferred: Fluency in pharmacy benefit design, specialty drug trend, and integrated medical-pharmacy value stories • Preferred: Track record of external thought leadership

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program • 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