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.

Reporting to the Chief Medical Officer, Health Care Services (HCS), the Senior Medical Director

partners with the CMO to provide leadership of clinical activities that play a pivotal role in

driving clinical excellence and innovation.

Leveraging advanced technologies and data analytics, the Senior Medical Director leads strategic initiatives to optimize outcomes, ensure regulatory compliance, and enhance the overall quality of the in-home evaluation (IHE) and diagnostic and preventative services (DPS). This position combines medical expertise, leadership acumen, client-centric communication and a forward-thinking approach to improve health on a scalable, impactful level.

The Senior Medical Director interacts and engages with internal and external stakeholders,

such as Executive Leadership, Signify network clinicians, Data Analysts and Data Scientists and

Product developers. They make strategic decisions based on their thorough understanding of

clinical quality management, healthcare industry issues, trends, and the regulatory landscape

and identifies opportunities for improvement and take initiative to improve both new and

existing programs.

What will you do?

Leadership And Team Management

• Provide strategic leadership including mentoring, coaching, and performance management.
• Collaborate with other functional leaders to ensure alignment and integration of clinical initiatives with overall organization goals
• Foster a culture of continuous learning, innovation, and excellence within the clinical team
  
  

Clinical Strategy And Oversight

• In collaboration with the Chief Medical Officer, develop and execute clinical strategies to improve health outcomes.
• Monitor and evaluate clinical performance metrics and outcomes, making data-driven decisions to drive improvement.
  
  

Quality Improvement And Monitoring

• Develop and implement quality improvement programs and initiatives to enhance member and provider safety, satisfaction and quality.
• Develop and implement quality improvement programs and initiatives to enhance clinician safety and satisfaction in collaboration with other stakeholders.
• Collaborate with stakeholders to identify areas for improvement and drive initiatives to address gaps and optimize processes.
• Clinical Documentation Accuracy (CDA):
• Lead efforts to monitor CDA, adherence to best practices, and Signify clinical guidelines across all clinical programs
• Work closely with data science and business enablement on methodology for reporting.
  
  

Regulatory Compliance

• Ensure compliance with regulatory requirements, credentialing standards, and quality metrics set by regulatory bodies and industry organizations.
• Oversee regulatory and compliance teams to develop and maintain policies, procedures, and documentation related to quality and clinical effectiveness.
  
  

Collaboration And Communication

• Collaborate with internal and external stakeholders to optimize member and provider experience and outcomes.
• Communicate effectively with executive leadership, presenting clinical insights, strategies, and performance reports.
  
  

Research And Innovation

• Stay updated with the latest clinical research, trends, and technologies relevant to diagnostic and preventative services.
• Drive innovation by identifying opportunities for new programs, services, or partnerships that enhance member care and outcomes.
• Support research initiatives aimed at evaluating solution outcomes.
  
  

Sales And Account Management Support

• Collaborate with the sales and business development teams to support client acquisition and retention efforts.
• Ensure provision of clinical expertise and insights during client meetings, presentations, and negotiations.
• Act as a medical advisor and liaison for key client accounts, addressing clinical
  
  

Basic Qualifications

• Active and current state medical license without encumbrances
• Board Certified MD or DO, Family Medicine or Internal Medicine preferred
• Ability to get additional state medical licenses as required for the business needs
• 15 years in a Healthcare Delivery System e.g., clinical practice and health care industry
• Ability to Travel: 20%
  
  

Preferred Qualifications

• Demonstrated experience in risk adjustment, health management and managed care
• Passion and ability to influence and drive better health outcomes in healthcare delivery Expertise/Fluency in clinical analytics/informatics
• Transformation/change management skills and experience and ability to develop business strategy to drive competitive advantage
• Exceptional verbal and written communication skills
• Desktop Tools - Microsoft Outlook, Microsoft PowerPoint, Microsoft Word, Excel
• Comfort with rapidly changing technology for engagement and analytics
• Performance Improvement.
• Experience in building and leading teams of clinicians.
  
  

Education

Board Certified MD or DO, Family Medicine or Internal Medicine preferred

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.

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.

Great Benefits For Great People

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including 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.
  
  

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 05/21/2025

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