Senior Network Medical Director, Central Region

CVS Health•Work At Home-Illinois, IL

2d•$184,112 - $396,550•Remote

About The Position

The Senior Network Medical Director serves as an enterprise clinical leader for healthcare provider relationships in the Central Region. The role adapts corporate network strategy to the region’s needs and capabilities and is accountable for provider performance on cost of care, quality, and member experience in collaboration with the regional Network team. The Medical Director evaluates provider performance, helps determine which partnerships to start, continue, or end, and partners with providers from a clinical perspective to support their success on behalf of members. The position works with Network, analytics, and actuarial teams and is part of the Medical Affairs network leadership team, collaborating to improve provider performance across lines of business. The role may provide coverage for other regions as needed while the team grows and ensures deliverables are completed on time and in accordance with federal and state regulatory requirements. The position is virtual, with occasional travel for in-person meetings.

Requirements

MD (Doctor of Medicine) or DO (Doctor of Osteopathic Medicine).
Active and current MD or DO medical license without encumbrances.
Board certification, including Maintenance of Certification, in a specialty of the American Board of Medical Specialties.
Five years of work experience in managed care, value-based care, and quality.
Three years of work experience in value-based care and quality.
Ability to work effectively in a highly matrixed organization or environment.
Ability to engage with physicians, vendors, community partners, administrative leaders, clinical leaders, and staff at all levels.
Ability to be agile, manage multiple priorities, and adapt to change with enthusiasm.
Ability to work virtually and travel occasionally for in-person meetings.

Nice To Haves

MBA or MPH.
Medical informatics and/or data science experience.
Location in the Central US.

Responsibilities

Serve as the primary clinical leader for healthcare provider relationships in the Central Region, working closely with and guiding senior clinical specialists.
Provide coverage for other regions as needed while the team is growing.
Partner with Network, analytics, and actuarial teams to evaluate provider performance on total cost of care, quality, and experience.
Shape the strategy for engaging value-based healthcare providers, including deciding where to expand or contract relationships.
Take accountability for provider-group performance on cost, quality, and experience, including measures important to lines of business such as MA Stars.
Participate in the Medical Affairs network team leadership and collaborate to improve provider performance across all lines of business.
Ensure timely completion of deliverables in accordance with due dates and federal and state regulatory requirements.