Senior Network Medical Director, Southeast Region

Job Title: Senior Network Medical Director, Southeast Region

Job Location: Work at Home, Connecticut, United States

Job Location Type: Remote

Job Contract Type: Full-time

Job Seniority Level: 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 & SummaryAt CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels, and more than 300,000 purpose-driven colleagues – caring for people where, when, and how they choose in a way that is uniquely more connected, more convenient, and more compassionate. And we do it all with heart, each and every day.

Aetna, a CVS Health company, is leading the industry in service of our members, providers, and plan sponsors across Medicare, Medicaid, and Commercial. Medical Affairs is a clinically focused center of excellence working in close collaboration with all Aetna business units and cross-enterprise partners, to ensure high value care and best-in-class operating and clinical models. We collaborate with members, providers, and community organizations in pursuit of quality solutions that address the full continuum of member health care and social determinant needs.

We are in search of a Senior Network MD who will serve as an enterprise clinical leader in shaping and executing our approach to driving performance on cost of care, quality, and member experience with our network of healthcare providers in the Southeast Region. They will adapt the corporate network strategy to the needs and capabilities of this region, and be accountable for outcome performance in this region in close collaboration with the Network regional team. They will be a clinical leader in determining what partnerships to start, continue, or stop, in evaluating provider performance, and in partnering with those providers from a clinical perspective to support their success on behalf of our members.

Join us in this exciting opportunity as we seek to continually improve our approach to partnership with value-based healthcare providers at Aetna.

Primary Job Duties & Responsibilities

• Serve as primary clinical leader for our relationships with healthcare providers in the Southeast Region, working closely with and providing guidance for senior clinical specialists. Fill in for other regions as needed while the team is growing.

• Partner with Network, analytics and actuarial teams to evaluate performance on total cost of care, quality, and experience for these providers

• Be a proactive strategic leader in shaping our strategy for engagement with these types of providers, including where to expand or contract our relationships

• Take accountability for performance of these groups on cost, quality, and experience, including measures of importance to lines of business, including MA Stars

• Be a part of the leadership team of the medical affairs network team, collaboratively working toward improving provider performance across all lines of business

• Ensure timely execution of all deliverables in accordance with due dates and Federal/state regulatory requirements.

Required Experience & Qualifications

• MD (Doctor of Medicine) or DO (Doctor of Osteopathic Medicine)

• Active and current medical license (MD or DO) without encumbrances

• Board Certification including Maintenance of Certification in specialty of American Board of Medical Specialties

• 5 years work experience in...