Lead Director – Clinical Innovation, Analytics Delivery

Job not on LinkedIn

🕒 August 11

🦌 Connecticut – Remote

🦌 Connecticut – Remote

💵 $100k - $231.5k / year

⏰ Full Time

🟠 Senior

👨‍⚕️ Medical Director

👻 Ghost score 45%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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

• Evaluate Utilization Management performance, market trends, regulatory developments, and emerging technologies • Lead strategic analyses, business cases, and investment recommendations shaping UM strategy and transformation priorities • Drive strategic portfolio planning, opportunity assessment, prioritization, resource alignment, funding recommendations, and value realization tracking • Partner with Clinical Operations, Product, Technology, and Enterprise Innovation teams on 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 • Build relationships across the organization and advise senior leaders on UM strategy, operational performance, automation, and 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 • Health domain certifications such as AHIP certifications preferred • Preferred: 5+ years of leadership experience in innovation, advanced analytics, business process optimization, enterprise consulting, strategic planning, financial analysis, risk management, or related disciplines • Preferred experience creating new capabilities, products, services, operating models, or automation solutions that deliver measurable business value • Preferred experience with Utilization Management modernization, intelligent workflow automation, and operational transformation initiatives • Preferred knowledge of Generative AI, machine learning, natural language processing, decision engines, APIs, workflow orchestration platforms, and predictive analytics • Preferred executive-level relationship management skills and ability to influence without direct authority • Preferred experience managing enterprise-wide portfolios and complex cross-functional initiatives • Preferred ability to translate ideas into actionable strategies and operational outcomes • Preferred ability to navigate ambiguity, shifting priorities, and evolving business needs

🏖️ Benefits

• 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

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