Medical Director responsible for managing clinical operations and providing strategic advice at Elevance Health. Overseeing health services and ensuring quality and cost - effectiveness in care delivery.
About the role
- VP & Chief Medical Officer leading clinical strategies to improve care quality and reduce costs at Aetna. Collaborating with business partners and driving operational excellence in healthcare management.
Responsibilities
- Leads organizational efforts to develop long range clinical strategy and roadmap, in alignment with business objectives related to cost of care, quality, and provider and member experience.
- Responsible for Aetna-wide clinical leadership and governance for all levers focused on reducing total cost of care while maintaining/improving care quality, including: care models, vendor partnerships, value-based arrangements.
- Partners closely with business leadership to set and achieve performance targets (PMPM, admissions/1,000, ED/1,000, MLR), and develops synthesized view and strategy with CMOs for UM, Network, as well as LOB CMOs.
- Ensures cross-functional operational excellence through deep payer experience, focused on delivering measurable results across Medicare, Commercial, and Medicaid.
- Responsible for monitoring trends, developing actionable clinical insights, creating integrated views of clinical opportunities and performance across lines of business and functions, proactively driving performance.
- Drives accountability and achievement across clinical leaders and functions responsible for provider network strategy and engagement, clinical program development and execution, and specialty care strategy and SME teams.
Requirements
- 15+ years of experience in clinical practice, healthcare management, or a related field, with at least 5 years in a leadership role focused on clinical strategy and innovation.
- Strong understanding of healthcare regulations, value-based care models, and population health management.
- Proven track record of successfully leading clinical initiatives that drive cost savings and improve quality of care.
- Exceptional leadership, communication, and interpersonal skills, with the ability to influence and engage stakeholders at all levels.
- Strong analytical and problem-solving skills, with a data-driven approach to decision-making.
- Ability to thrive in a fast-paced, dynamic environment and manage multiple priorities effectively.
Benefits
- Affordable medical plan options
- 401(k) plan (including matching company contributions)
- Employee stock purchase plan
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
- Paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
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