Medical Director – Senior Clinical Solution, Population Health

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🔥 1 hour ago

🦌 Connecticut, Maryland, +3 more states – Remote

🦌 Connecticut – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote ❄️ Minnesota – Remote 🤠 Texas – Remote

💵 $184.1k - $396.6k / year

⏰ Full Time

🟠 Senior

👨‍⚕️ Medical Director

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

Healthcare Insurance • Retail • Wellness

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

• Analyze policy/procedure/workflows on case management and utilization management for care redesign • Analyze Total Cost of Care, Stars, Risk Adjustment, etc. data for opportunities and propose Strategic Action Items and other initiatives to improve outcomes • Work collaboratively with Medical Economics Unit, Analytics and Behavioral Change, Aetna Clinical Services and Medical Affairs’ other departments to improve Medicare business operations and clinical program execution • Develop and improve Medicare reporting, such as, in Tableau • Lead and implement informatics communication efforts • Strong collaborative relationship with care management teams • Active participation in meetings and communications, including team meetings, leadership meetings, at the health plan local, state, regional or national levels • Other duties as assigned

🎯 Requirements

• Board certification in Medical Informatics preferred • Masters in related field preferred • 5 years work experience in managed care required (preferably in Medicare) • Experience in care model design and implementation, population health program development and/or clinical product development preferred • Medical informatics and/or data science experience preferred • Care Redesign experience required • Must meet COVID-19 requirements • Active and current state medical license without encumbrances • M.D. or D.O., Board Certification in a recognized specialty including post-graduate direct patient care experience

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families