VP, Chief Medical Officer - High Value Care

CVS Health • Boston, MA

8d • $300,000 - $400,000 • Hybrid

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. Aetna is seeking to hire a Vice President & Chief Medical Officer (CMO) of High Value Care. This Aetna Medical Affairs leadership role will report directly to Aetna’s Senior Vice President & Chief Medical Officer. The VP & CMO of High Value Care serves as the Medical Affairs leader accountable for driving high‑value care performance across lines of business by enabling, integrating, and coordinating the efforts of the Line of Business (LOB) CMOs, Network CMO, and their teams. The role is intentionally designed to accelerate LOB and Network clinical performance, while ensuring that Aetna’s highest‑impact clinical levers are executed with discipline, alignment, and measurable results. This leader is accountable for Aetna-wide outcomes related to total cost of care, quality, and sustainability, achieved by establishing clear strategy, common measurement, transparent prioritization, and rigorous execution across LOBs. Success is defined by the ability to translate organizational strategy into coordinated action, drive performance, and ensure that LOB clinical teams are positioned to deliver against shared goals. The role partners closely with business segment leadership, Network, Aetna Clinical Solutions, and the Aetna Medical Affairs COO to ensure that high‑value clinical strategies are consistently executed, monitored, and continuously improved across Medicare, Commercial, and Medicaid.

Requirements

• 10+ years of experience in clinical practice, healthcare management, or related fields
• 5+ years in senior clinical leadership roles
• Deep expertise in value‑based care, population health, healthcare economics, and regulatory environments, particularly related to payer levers around cost and quality management.
• Proven track record of driving measurable clinical and financial performance in large, complex, matrixed organizations.
• Demonstrated ability to influence without authority while maintaining strong accountability for results.
• Exceptional communication, analytical, and systems‑thinking capabilities.
• Ability to operate effectively in fast‑paced environments with multiple, interdependent priorities.
• Medical degree (MD or DO) with board certification in a relevant specialty (required)

Nice To Haves

• Advanced degree in healthcare administration or public health (preferred)

Responsibilities

• Clinical Strategy & Performance Alignment Advances high‑value care strategy, ensuring alignment to Aetna’s affordability, quality, and experience objectives, and translating strategy into clear, actionable priorities across lines of business.
• Partners with Business leadership, LOB CMOs, Network, and Aetna Clinical Solutions to co‑develop a shared clinical roadmap, aligning organizational goals with LOB‑specific strategies and market needs.
• Establishes and maintains Medical Affairs-performance expectations and design frameworks for cross‑LOB value levers (e.g., care models, vendor partnerships, value‑based arrangements)
• Drives alignment on common performance metrics, targets, and reporting (e.g., PMPM, admissions per 1,000, ED visits per 1,000, MLRj, and med cost impact from clinical initiatives), enabling transparent tracking of progress and results across the organization.
• Provides enterprise‑level synthesis of insights across Medicare, Commercial, and Medicaid Execution, Operating Rigor & Accountability Accountable for design and execution discipline for high‑value care initiatives, ensuring that priorities are clearly defined, sequenced, resourced, and delivered on time and with impact.
• Establishes and operates a standardized clinical operating model in partnership with the Aetna Medical Affairs COO, including shared roadmaps, integrated Gantt charts, dependency management, and clear ownership across LOBs and functions.
• Drives clarity around initiative ownership, milestones, interdependencies, and expected outcomes, holding the system accountable for execution and progress
• Actively monitors performance, identifies gaps or risks, and intervenes through alignment, escalation, or re‑prioritization to ensure enterprise goals are met.
• Anticipates regulatory, legislative, and market risks and mobilizes cross‑LOB leadership to align on mitigation strategies and course correction.
• Cross‑LOB Capabilities, Measurement & Insight Generation Collaborates with medical economics and business leadership to proactively surface and manage enterprise trends, ensuring early identification of risk and opportunity and driving timely, coordinated response across lines of business.
• Leads development and continuous improvement of Medical Affairs capabilities for clinical measurement, evaluation, and analytics, collaborating closely with medical economics and enterprise analytics, to ensure consistent assessment of clinical and financial impact.
• Builds and oversees a best‑in-class evaluation and measurement function supporting care models, vendor partnerships, and value‑based care arrangements, enabling data‑driven decisions and performance accountability.
• Drives development of high impact clinical insights to identify and prioritize high‑value opportunities
• Ensures insights are translated into clear, actionable priorities with defined owners, timelines, and success measures.
• Establishes consistent approaches to identifying and tracking scorable action items that contribute to measurable improvements in cost, quality, and experience.
• Advances transformative care innovations that can accelerate high value care, including AI, digital engagement, novel therapeutics and approaches, etc.
• Network, Provider & Market Performance Enablement Partners with Network and LOB CMOs and business leadership to align provider strategy, innovation, and value‑based relationships with Aetna’s high‑value care objectives.
• Drives coordination and scaling of successful clinical and provider initiatives, ensuring that market differentiation is grounded in demonstrable performance and outcomes.
• Evaluates clinical and business impact of partnerships and programs in partnership with LOB leaders, making clear recommendations to scale, adapt, or sunset initiatives based on results.
• Coordination Across Aetna Medical Affairs (LOBs, Network, UM/Appeals, Quality, COO) Setting clear priorities and expectations around TCOC and quality initiatives: Creating shared visibility into timelines, dependencies, and progress.
• Establishing common metrics, targets, and reporting.
• Coordinating resources and sequencing across LOBs.
• Removing barriers to execution and accelerating adoption of what works.

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
• Education Level: Ph.D. or professional degree