Clinical Program Consultant (CPC)

Job DescriptionExciting opportunity with Aetna's Plan Sponsor Insights team for an experienced clinician with an intellectual curiosity and desire for continuous learning and passion to improve population health. The successful Clinical Program Consultant (CPC) is highly collaborative, energetic, and organized in their approach to customer data analysis. They work proactively with the account team, care management teams, Plan Sponsor Insights, and other key enterprise partners to support our commercial plan sponsors.As a member of the Plan Sponsor Insights (PSI) team the CPC fulfills the company mission of helping people on their path to better health by leveraging clinical, analytical, and consultative skills to evaluate benefit design and plan performance for our customers. In this role, the CPC is empowered to: Provide progressive consultative clinical insights based on analysis of clinical plan utilization and impact of member behavior on medical plan costs Influence recommendations for clinical programs and services that align with the customer's strategy and help drive short- and long-term results Analyze, synthesize, and present clinical content with recommended actions to drive member behavior change and help improve plan performance in customer facing meetings Act as a trusted clinical resource educating constituents about population health, industry trends, and impact of health disparities Collaborate across the enterprise to drive goal alignment with the customer and the health plan Provide input to customer's population health strategy across the clinical spectrum Create and propose solutions to improve member health including leveraging community opportunities and resourcesThis is a customer-facing role with up to 50% travel to meet with customers and review plan performance, discuss recommendations, etc. The position is work from home except for the required customer travel as noted. Preference will be given to candidates living near (within 2 hours of) a major airport. The candidate accepting the CPC position is hired into the Mgr. Business Consultant job grade. Preferred WAH states: Texas, Colorado, Oregon, Washington. Central/Pacific Time Zone preferred.CPCs are key members of the Plan Sponsor Insights business - a business focused on providing insights and solutions based on analytics to customers in the group commercial business. The work environment supports and thrives on creative talent, and a consultative approach. Our team consists of physicians, nurses, clinical social workers, well-being, and analytic consultants. Our support is highly valued by our internal partners as well as the customers we serve.Pay RangeThe typical pay range for this role is:Minimum: 60,300Maximum: 130,000Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.Required Qualifications Minimum of 5 years clinical experience (3 years in acute care, the other 2 years may be a combination of different sites of care including: hospital, clinic, and/or community health, managed care) 1+ years of healthcare consultation experience working with external constituents 1+ years presenting health-related content to decision makers 2+ years utilizing Excel and other reporting mechanisms to support analysisPreferred Qualifications Unrestricted active registered nurse license 1+ years leadership experience Experience working with a health insurance carrier Experience with benefit plan design Adept at communicating chronic conditions' impact on population health Strong problem-solving skills and attention to detail Strong clinical analytic skills and demonstrated conceptual thinking. This includes utilizing Excel and other reporting mechanisms to support analysis Proficient consultative, communication and presentation skills (especially PowerPoint) Ability to establish highly collaborative relationships within and outside the organization including at the executive level Proficient with MS Office programs (Excel, PowerPoint, Word, and Outlook) Bachelor's degree in nursing or MSW/LCSW 1+ years organizing and responding to multiple deliverables in a timely and professional mannerEducationBachelor degree - Bachelor's degree in nursing or MSW/LCSW preferredBusiness OverviewBring your heart to CVS Health Every 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. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

Created: 2025-11-01