Medical Director - Sr Clinical Solution - Population ...

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.Position SummaryThe Sr. Clinical Solutions Medical Director, Population Health, Medicare position will serve as the liaison between data analytics/reporting teams and the clinical leadership team to identify trends in population health while providing a clinical perspective to effectively communicate and support clinical solutions aimed at improving patient care, safety and health outcomes of the Medicare membership. The role will leverage existing data and reporting sources as well as develop new analytics to support health plan senior leadership to identify, develop, implement, and evaluate the effectiveness of strategic initiatives including trends, policies and programs, designed to drive the delivery of high value healthcare supporting a sustainable competitive business advantage for members.Report directly to the VP/CMO Medicare and take direct assignment of significant projects which are foundational to the Medicare Medical Affairs agenda.ResponsibilitiesAnalyze policy/procedure/workflows on case management and utilization management for care redesignAnalyze Total Cost of Care, Stars, Risk Adjustment, etc. data for opportunities and propose Strategic Action Items and other initiatives to improve outcomesWork collaboratively with Medical Economics Unit, Analytics and Behavioral Change, Aetna Clinical Services and Medical Affairs' other departments to improve Medicare business operations and clinical program executionDevelop and improve Medicare reporting, such as, in TableauLead and implement informatics communication efforts Strong collaborative relationship with care management teamsActive participation in meetings and communications, including team meetings, leadership meetings, at the health plan local, state, regional or national levelsOther duties as assignedRequired QualificationsBoard certification in Medical Informatics preferredMasters in related field preferred5 years work experience in managed care required (preferably in Medicare)Experience in care model design and implementation, population health development and/or clinical product development preferredMedical informatics and/or data science experience preferred Care Redesign experience requiredMust meet COVID-19 requirementsThis is a remote/work from home position within the United States This role requires overnight travel up to 30% of the timeEducationActive and current state medical license without encumbrancesM.D. or D.O., Board Certification in a recognized specialty including post-graduate direct patient care experiencePay RangeThe typical pay range for this role is:$184,112.00 - $396,550.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.Additional details about available benefits are provided during the application process and on Benefits Moments.We anticipate the application window for this opening will close on: 04/17/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Created: 2026-04-15