Senior Network Medical Director, Central Region

9025 CVS Shared Services Resources LLC; Illinois; Hybride; USD 184 000 - 397 000; Plein temps

Avantages offerts par ce poste

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Résumé du poste

CVS Health is seeking a Senior Network MD to lead clinical partnerships with providers in the Central Region. You’ll drive performance on cost of care, quality, and member experience, aligning with our network strategy and regional team.

The role requires MD/DO with board certification, an active license, and 5+ years in value-based care. Occasional travel and collaboration across lines of business are expected.

Qualifications

• MD or DO physician with active license and ABMS board certification.
• 5+ years in managed care, value-based care, and quality.
• 3+ years in value-based care and quality.
• Able to thrive in a highly matrixed organization and engage at all levels.
• Willingness to travel occasionally for in-person meetings.

Responsabilités

• Serve as primary clinical leader for the Central Region in partnerships with healthcare providers.
• Collaborate with Network, analytics and actuarial teams to evaluate cost of care, quality, and member experience.
• Shape engagement strategy, including expansion or contraction of provider relationships.
• Own performance metrics for cost, quality, and experience across lines of business.
• Contribute to leadership in the Medical Affairs network team and drive provider performance improvements.
• Ensure timely delivery of all deliverables respecting regulatory requirements.

Connaissances

Leadership

Stakeholder engagement

Matrixed organization

Travel readiness

Communication skills

Formation

MD or DO medical degree

Board Certification (ABMS)

Active medical license

MBA or MPH (preferred)

Description du poste

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 & Summary At 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 Central 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 Central 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 the areas of managed care, value-based care, and quality
• 3 years work experience in value-based care and quality
• Ability to work effectively in a highly matrixed organization / environment
• Ability to engage at all levels, including physicians, vendors, community partners, administrative leaders, clinical leaders, and staff
• Ability to be agile, manage multiple priorities, and adapt to change with enthusiasm
• Ability to work virtually with occasional travel for in person meetings

Preferred Experience & Qualifications

• MBA or MPH
• Medical informatics and/or data science experience

Location

Central US

Education

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

Pay Range

The typical pay range for this role is: $184,112.00 - $396,550.00. This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program.

Benefits

• Medical coverage
• Dental coverage
• Vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources, based on eligibility

Great benefits for great people. We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. Additional details about available benefits are provided during the application process and on Benefits Moments.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Our Work Experience is the combination of everything that’s unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it’s our