The Medical Director - Physician Services will support Clinical Quality Programs related to provider quality assessments and member support solutions.
This position will provide clinical support for Provider Analytics and Network teams to develop and implement solutions that ensure accurate assessment of Aetna provider quality and efficiency for implementation of member-facing solutions.
You will also work closely with external quality organizations, including Medical Societies, Data Registry Groups, National Quality Organizations (such as NCQA, NQF) and vendors to improve CVS-Aetna's clinical quality programs for all lines of business.
Full Time Position
Supervisory Responsibilities - No
Percent of Travel Required - 10 - 25%
Telework Position - Yes
Three (3) or more years of experience in the health care delivery system e.g., clinical practice and health care industry.
Exceptional oral and written communication skills.
Previous experience with provider quality performance measurement systems and methodologies (HEDIS Metrics, ETG Methodology, IOE designations).
Leadership qualities that engage, inspire and develop internal and external stakeholders.
Transformation/change management skills and experience and ability to develop business strategy to drive competitive advantage.
Comfort with rapidly changing technology for engagement and analytics.
Ability to make strategic decisions based on a thorough understanding of clinical quality management, healthcare industry issues, trends, and the regulatory landscape.
Ability to interact and engage with Executive Leadership, Medical Professionals, Medical Societies and other National Quality Organizations, and Data Analysts.
Experience working with Analytics teams to test hypotheses and validate results.
Proven ability to develop and execute strategy
Healthcare Insurance / Managed Care experience
M.D. or D.O., Board Certification in an ABMS recognized specialty including post-graduate direct patient care experience
Active and current state medical license without encumbrances
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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