Director Clinical Operations - ACO Reach

Job DescriptionAetna, a CVS Health Company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity to help transform health care. We believe that a better care system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources. This is a remote based (work from home) role.The Director Clinical Operations - ACO Reach maintains oversight of all inbound and out bound outreach, and all clinical products implementation and services delivery. Executes strategic and operational plans in support of business segment services objectives and initiatives. Sets business area priorities, allocates resources and develops plans for multiple related teams. Ensures all critical service metrics and operational results are achieved. Leads multiple leaders of a highly customized operations. Potential to oversee multiple service centers and/or sites of delivery. Directs implementation of service standards for each location to ensure delivery of evidence-based, clinically accurate, quality-focused, consistent, cost-effective services and administration. Analyzes operational practices for effectiveness and practicality, while creating a culture which is innovative in its approach to solutions. Establishes a clear vision aligned with company values, including health equity; sets specific challenging and achievable objectives and action plans; motivates others to balance customer needs, budgets, and business success. Develops an organization that attracts, selects, and retains high caliber, diverse talent able to successfully achieve or exceed business goals; builds a cohesive team that works well together and across other business segment functions. Leads and builds high performance teams across units by providing leadership, mentoring, and coaching in achieving understanding of the voice of the customer. Coordinates major plan modifications necessitated by unanticipated business or technology developments. This position reports to the CMO for CVS Health Accountable Care Organization.Required Qualifications RN or Advanced Practice Nursing. 5+ years' experience in managing care delivery in a provider setting, including managed care, ACO, and/or other alternative payment mechanisms. 3+ years experience managing Medicare populations. 5+ years strong leadership skills managing high-performance teams. 3+ years experience working with vendors.COVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred Qualifications Master's degree in closely related field. Experience managing clinical programs on the provider side. Ability to manage high volume inbound/outbound engagement call center for clinical operation programs. Including project delivery, production, systems analysis, and application program development. Demonstrated negotiation skills.EducationRN Diploma, Associates or B.S. degree in nursingBusiness OverviewBring your heart to CVS HealthEvery one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Created: 2026-03-07