Executive Medical Director, Clinical Business Solutions

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Job Purpose and Summary:

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.

Primary Job Duties & Responsibilities:

• Lead, coach, and develop a team of clinicians (MD/RN/NP) providing clinical support across National Accounts, Large Group, and Public & Labor segments

• Share directly in the team’s external responsibilities, including: 1) personally cultivating and holding relationships with key brokers, consultants, and plan sponsors, and 2) personally leading clinical sales activities for high-profile prospects

• Continuously improve how the team operates — coverage, prioritization, preparation, and materials — to increase the level and quality of clinical support provided to the Field

• Define the team’s coverage model; assign and manage named client and producer coverage, allocating clinical capacity against pipeline value, retention risk, and strategic importance in partnership with Field leadership

• Set and raise the standard for clinical narratives, presentation materials, and meeting preparation across all clinicians engaged in plan sponsor-facing activities, including those outside the direct reporting line

• Own hiring, onboarding, performance management, development planning, and succession for the team

• 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, working closely with Clinical Operations, Clinical Product, and Medical Affairs to ensure the story presented to the market is current and accurate

• Keep Field teams current on Aetna’s clinical programs — spanning medical, behavioral health, pharmacy, and vendor partnerships — through regular briefings and training, and support their preparation for client and prospect meetings

• 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; identify drivers and recommend clinical program actions with a credible view of expected impact

• Own a formal producer engagement model: hold named, assigned relationships with priority national and regional benefits consulting firms, brokers, and general agents, and assign and oversee equivalent named coverage across the team

• Serve as the senior clinical counterpart to assigned consultant firms, maintaining a defined cadence of clinical briefings, capability updates, and roadmap previews at both national practice-leader and local office level

• Lead clinical responses to consultant capability surveys, market scans, and program and vendor assessments conducted by producer firms

• 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

• Partner with stakeholders across Aetna and with key business partners in the PBM and consumer businesses to ensure customer needs are reflected in products and services offered

• Surface competitive gaps, emerging plan sponsor requirements, and point-solution pressure early enough to inform build, buy, and partner decisions

• Maintain active command of Commercial market dynamics, competitor clinical strategy, health policy, and the evolving clinical program and point-solution landscape

• Represent Commercial Medical Affairs in relevant governance forums and cross-functional working groups

• Ensure all externally presented clinical claims are evidence-based, accurate, and defensible

The typical pay range for this role is: