[Hiring] Executive Medical Director, Clinical Business Solutions @CVS Health

Role Description

Join a mission-driven organization at a transformative moment in employer-sponsored health care. As Executive Medical Director, Clinical Business Solutions at Aetna, a CVS Health company, you will lead the clinical team that serves as the clinical voice to our Commercial plan sponsors, prospects, and their advisors, demonstrating how Aetna’s clinical capabilities reduce cost, improve population health, and strengthen the member and provider experience.

Reporting directly to the Vice President, Chief Medical Officer, Commercial & Innovation, you will direct a national team of clinicians (MD, RN, NP) providing clinical support to Aetna’s National Accounts, Large Group, and Public & Labor businesses, in close partnership with Field and Account teams.

You will lead and continuously improve the operations of the team to raise the level and quality of clinical support delivered to the Field, while sharing directly in its external work — including personally cultivating and holding relationships with key brokers, consultants, and plan sponsors.

The role is deliberately bidirectional. You will bring the voice of the customer and the producer community back into the organization, partnering with Clinical Operations, Medical Affairs, Commercial Product, and others to ensure our clinical offerings reflect what the market requires.

We are seeking a commercially fluent physician leader with a strong command of Commercial health insurance, a demonstrated externally facing track record, the executive presence to establish credibility with sophisticated buyers and advisors, and a clear orientation toward building and developing a team.

Qualifications

• 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 — for example finalist presentations, strategic client reviews, consultant and broker engagement, or equivalent commercial-facing responsibility
• Deep working knowledge of employer-sponsored Commercial health insurance, including funding arrangements (self-funded/ASO, fully insured, stop-loss), benefit design, utilization management, care management, network, and pharmacy integration
• Demonstrated ability to translate clinical and claims data into a clear business narrative for non-clinical executive audiences, including CHRO, CFO, and benefits leadership
• Exceptional executive presence and platform skills; proven ability to establish personal credibility and build durable relationships with sophisticated external buyers and intermediaries, in both formal meeting settings and informal client and industry settings
• Experience leading, coaching, or formally mentoring clinical colleagues
• Exceptional stakeholder management skills; demonstrated ability to build coalitions and drive alignment across diverse, matrixed internal audiences
• Fully remote position; ability to travel approximately 25–50% for client, producer, and Field meetings

Requirements

• Serve as the senior clinical leader for new business pursuits including finalist meetings, clinical sections of RFP responses, and clinical strategy sessions
• Cultivate relationships with clinical, benefits, and human capital decision-makers and influencers at prospective plan sponsors
• Partner with Sales leadership and Account Executives to develop strategic clinical messaging and articulate Aetna’s clinical differentiation against competitor positioning
• Keep Field teams current on Aetna’s clinical programs through regular briefings and training
• Translate the Aetna clinical program portfolio into prospect-specific value narratives tied to total cost of care, population health outcomes, and member and provider experience
• Serve as clinical partner for retention and growth across the existing book: strategic client reviews, multi-year clinical roadmaps, and outcomes and affordability discussions
• Partner with Medical Economics and Analytics colleagues to interpret client-specific utilization, cost, and quality data
• Own a formal producer engagement model: hold named, assigned relationships with priority national and regional benefits consulting firms, brokers, and general agents
• Represent Aetna clinically at consultant forums, market events, industry conferences, and employer coalitions
• Systematically capture, synthesize, and channel plan sponsor, producer, and Field feedback into Clinical Operations, Clinical Product, Commercial Product, and Medical Affairs roadmaps
• Maintain active command of Commercial market dynamics, competitor clinical strategy, health policy, and the evolving clinical program and point-solution landscape

Benefits

• Comprehensive and competitive mix of pay and benefits
• Medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Wellness programs and other resources, based on eligibility