Executive Director, Clinical Vendor Performance

CVS Health

2d • Remote

About The Position

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. Position Summary At Aetna, our health benefits business, we are committed to helping our members achieve their best health in an affordable, convenient, and comprehensive manner. Combining the assets of our health insurance products and services with CVS Health’s unrivaled presence in local communities and their pharmacy benefits management capabilities, we’re joining members on their path to better health and transforming the health care landscape in new and exciting ways every day. Aetna is seeking an Executive Director of Clinical Vendor Performance who will play a key leadership role in overseeing and optimizing the performance of clinical vendors and delegated entities. This position is responsible for driving improved health outcomes, ensuring regulatory compliance, and advancing cost‑efficient care delivery.

Requirements

• The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment.
• This position offers broad exposure to all aspects of the company’s business, as well as significant interaction with all the business leaders.
• The candidate will be expected to have the following key attributes:
• 15+ years of Managed Care experience with a strong focus on clinical vendor management.
• Deep expertise in regulatory requirements, industry standards, and best practices for delegated vendor oversight.
• Provide robust clinical and operational leadership to shape vendor strategy and ensure high‑quality, member‑focused care delivery.
• Promote a culture of continuous improvement and innovation across vendor management processes and outcomes.
• Lead the development and execution of innovative clinical strategies that advance business goals and elevate care quality through external partners.
• Experienced in conducting quality oversight of clinical and operational vendors.
• Skilled in designing forward‑thinking clinical strategies that drive performance, efficiency, and member outcomes.
• Demonstrated leadership strength with a strong bias for operational execution and results.
• Proven ability to build a new team from the ground up and lead it to sustained high performance.
• Experienced working with federal, state, and regulatory agencies.
• Adaptable, collaborative, and effective in dynamic, changing environments.
• Strong business and financial acumen.
• Proven executive presence with the ability to engage and influence internal and external stakeholders.
• Operational expertise in building business models and analyzing complex data.
• Open to remote work opportunities across the United States.

Responsibilities

• Strategy Development and Leadership: Develop and lead a comprehensive strategy for managing delegated partner performance, ensuring alignment with organizational goals and value-based care objectives.
• Governance Frameworks: Design and maintain effective governance frameworks to proactively identify, monitor, and mitigate performance risks within the delegated network.
• Performance Metrics: Define, track, and analyze key performance indicators (KPIs) across clinical, operational, financial, and compliance metrics to gain a holistic view of vendor effectiveness.
• Monitoring and Reporting: Implement robust monitoring and reporting mechanisms to track vendor performance against established benchmarks and service level agreements (SLAs).
• Continuous Improvement: Drive sustained improvement in delegated performance through continuous monitoring, identification of areas for enhancement, and implementation of corrective action plans when needed.
• Performance Reviews and Audits: Conduct regular performance reviews and audits of delegated entities to ensure compliance with contractual obligations, regulatory requirements, and organizational standards.
• Vendor Scorecards: Implement vendor scorecards to systematically assess and rate vendor performance on a regular basis (e.g., quarterly or annually).
• People Leadership: This role will be responsible for building a new team from the ground up and leading it to consistently achieve high performance.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Executive
• Number of Employees: 5,001-10,000 employees