Executive Medical Director - Medical Policy & Operations

Clinical Careers Page(2 months ago)

HybridFull TimeExecutive$227,630 - $490,280Medical Policy & Operations

About this role

The Executive Medical Director, Medical Policy & Operations at CVS Health leads clinical strategy related to medical and payment policy to support medical management programs and accurate administration of plan benefits. This role partners across Aetna and other business units to align clinical policy with business objectives and improve clinical and financial outcomes. The position reports at the executive level and represents the organization’s clinical leadership in policy development and cross-functional collaboration.

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Required Skills

Clinical Expertise
Medical Policy
Payment Policy
Team Leadership
Policy Development
Claims Review
Recruiting
Training
MedCompass
MedHok

+4 more

Qualifications

MD or DO
Medical Director Board Certification
Active State Medical License

About Clinical Careers Page

cvshealth.com

CVS Health is America's leading health solutions company, providing integrated services across retail pharmacy (CVS Pharmacy), pharmacy benefits management (CVS Caremark), and health insurance (Aetna). The company offers pharmacy services, health plans, clinical care (including MinuteClinic), and health-and-wellness programs for consumers, employers, and government payers. By combining a large national retail footprint with claims processing, care management, and clinical services, CVS Health aims to coordinate care, lower costs, and improve health outcomes. Businesses and consumers use its solutions for medication management, plan administration, and in-person and virtual care.

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