Lead Director, Clinical Business Support Specialist - Aetna Commercial

CVS Health

9d • $100,000 - $231,540 • 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 The Lead Director, Clinical Business Support Specialist will sit on the Clinical Business Support team within Sales Enablement and will provide multi‑lateral clinical support to field and account teams, employers, and healthcare consultants. This role primarily supports Large Group customers located in the West and Central regions. This role supports clinical discussions, presentations, and related activities to help commercial plan sponsors advance the quintuple aim —reducing costs, improving population health, optimizing patient and provider experiences, and driving awareness of equity and inclusion. To achieve this, the Lead Director, Clinical Business Support Specialist will demonstrate leadership across the following core activities: high‑cost claimant reviews; periodic plan performance reviews; review and articulation of the company’s clinical models, programs, and point solutions; RFI/RFP support, capabilities presentations, and finalist meetings; partnering with consultants, brokers, and producers; answering clinically related account questions; and developing health promotion and prevention strategies. This role will also be responsible for bringing the voice of the customer back to the organization to ensure customer needs are being met through the products and services offered. This includes partnering with numerous stakeholders across Aetna, as well as key business partners within the PBM and consumer businesses. This is a fully remote position requiring approximately 25–50% travel for client meetings. Many client meetings are held in person; therefore, this role requires a moderate level of business travel across the Central and Western United States.

Requirements

• Clinically licensed healthcare professional (RN, PA, NP) with an active, unrestricted/unencumbered license
• 10–15 years of relevant work experience
• 5–10+ years of experience as a clinician or clinical leader with a large national health plan, consultant, or medical management company within the commercial healthcare space
• Licensed healthcare professional (RN, PA, NP)
• Ability to travel 25–50%

Nice To Haves

• Registered Nurse (RN), Advanced Practice Nurse (APN), or Physician Assistant (PA)
• Master’s degree preferred (MSN, MPH, MS, MHA, MMM, MBA, etc.) or equivalent experience

Responsibilities

• high‑cost claimant reviews
• periodic plan performance reviews
• review and articulation of the company’s clinical models, programs, and point solutions
• RFI/RFP support, capabilities presentations, and finalist meetings
• partnering with consultants, brokers, and producers
• answering clinically related account questions
• developing health promotion and prevention strategies
• bringing the voice of the customer back to the organization to ensure customer needs are being met through the products and services offered
• partnering with numerous stakeholders across Aetna, as well as key business partners within the PBM and consumer businesses

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: Director