National Accounts Lead Director, Clinical Program Consultant (CPC)

CVS Health•New York, NY

11d•$100,000 - $231,540

About The Position

The National Accounts Lead Director, Clinical Program Consultant (CPC) serves as a consultative strategic partner, reviewing clinical data and trends, evaluating clinical program effectiveness, and identifying clinical cost drivers. The role analyzes high-cost claimants and engages medical directors and clinical resources as needed, with the goal of recommending ways to improve the overall health of customer populations. The CPC leader partners with business owners to advance strategic objectives, including profitable growth and improved organizational effectiveness. The role partners with account teams to recommend clinical programs that mitigate medical cost trends and optimize return on investment, using an analytic platform to identify cost and utilization drivers across medical and behavioral conditions. The Lead Director oversees a team of approximately 7–8 Clinical Program Consultants, directs their customer-facing work, aligns resources with Field partner and customer needs, and coaches and develops team members. The position may also work directly with customers in a strategic advisory capacity. In collaboration with Aetna National Accounts Field Sales and Service staff and account teams, the Lead Director identifies customers who may benefit from clinical management programs, analyzes medical, pharmacy, behavioral health, and disability trends, and recommends tailored cost-management strategies and program improvements. The role seeks strong clinical and financial outcomes, addresses gaps in customer programs, manages changing projects and priorities, and serves as a key resource on clinical programs for Aetna National Accounts. The position is open to qualified candidates anywhere in the Eastern United States and is described as a remote/hybrid opportunity.

Requirements

7+ years of experience in the healthcare industry, well-being, healthcare consulting, client reporting and analytics, clinical operations, and business management.
Minimum 7+ years of diverse clinical and well-being experience.
Ability to lead and collaborate across teams.
Prior experience managing and/or leading teams.
Bachelor's degree or equivalent work experience.

Nice To Haves

Unrestricted RN or LCSW license.

Responsibilities

Lead a team of approximately 7–8 Clinical Program Consultants.
Provide day-to-day oversight of the customer-facing work performed by the Clinical Program Consultants.
Set priorities and align appropriate resources with the needs of Field partners and their customers.
Collaborate with Field leaders to understand business retention and growth objectives and determine how CPC work can support them.
Coach and develop team members so they can maximize their potential.
Work directly with customers in a strategic advisory role as needed.
Collaborate with Aetna National Accounts Field Sales and Service staff to identify customers who may benefit from Aetna medical, dental, pharmacy, behavioral health, and disability clinical management programs.
Evaluate and analyze medical, pharmacy, behavioral health, and disability trend drivers, and propose clinical programs or improvements to manage those trends.
Consult with clients, in collaboration with Aetna account teams, on employee population trends and tailor cost-management strategies.
Maximize clinical and financial outcomes from recommended clinical programs and improvements.
Identify and help rectify clinical program gaps for customers using Aetna clinical management programs.
Manage changing projects and priorities to completion and mitigate negative outcomes arising from market and competitive dynamics.
Serve as a key resource on clinical programs for Aetna National Accounts.
Evaluate performance through regular, timely feedback to support exceptional service delivery, engagement, motivation, and team development.