Chief Medical Quality Officer

CVS Health; Connecticut; Hybrid; USD 184,000 - 397,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health, through its Aetna Medical Affairs MD Quality function, seeks an Executive MD Quality Lead to shape the future state of MD quality governance. You will lead methodological upgrades, calibration, and cross-LOB alignment to ensure clinically sound MD decisions across lines of business.

The role drives governance, performance oversight, and accountability, partnering with ACS to advance enterprise-wide quality improvements and ensure member-first outcomes.

Qualifications

• Leadership experience in clinical quality or MD performance calibration
• Strong understanding of clinical coverage determinations and medical necessity criteria
• Experience designing structured training programs to improve performance
• Ability to influence senior clinical and business leaders in a complex organization
• Experience with quality metrics, audit findings, and governance

Responsibilities

• Oversee governance of Aetna’s centralized MD Quality function, ensuring alignment with enterprise standards and regulatory requirements
• Lead a multidisciplinary team to strengthen audit rigor and consistency in MD reviews
• Analyze decision trends to identify high-impact areas for targeted improvement
• Evaluate audit methodologies to ensure actionable, defensible findings
• Lead MD Quality forums to set standards and drive cross-LOB alignment
• Prioritize quality improvement and remediation efforts with high impact
• Oversee tracking of quality metrics and outcomes for accountability
• Represent MD Quality in executive forums with performance updates and risk mitigation
• Serve as trusted clinical advisor promoting a culture of quality and accountability
• Own cross-functional partnership with ACS for E2E alignment and quality improvement

Skills

Leadership

Clinical expertise

Regulatory knowledge

Analytical skills

Executive communication

Education

Board-certified MD or DO

Healthcare quality/public health training

Job description

CVS Health, through its Aetna Medical Affairs MD Quality function, seeks an Executive MD Quality Lead to shape the future state of MD quality governance. You will lead methodological upgrades, calibration, and cross-LOB alignment to ensure clinically sound MD decisions across lines of business.

The role drives governance, performance oversight, and accountability, partnering with ACS to advance enterprise-wide quality improvements and ensure member-first outcomes.