Job DescriptionThe CMO will support Aetna Better Health of NY as well as Aetna Better Health of PA and serve as clinical lead for both Medicaid Plans. 1. The Chief Medical Officer (CMO) is the clinical lead of the state health plan.2. The state CMO works collaboratively with the national Medicaid CMO, and the senior leadership of the designated business unit nationally and regionally to achieve overall company goals of growth, financial performance including cost of care and, clinical quality improvement.3. The CMO works closely with the national Medicaid CMO, members of the national corporate clinical executive team, and most tightly with the state health plan leadership team to create and implement national medical and clinical policies and programs for the state health plan.4. Operating with a balance of internal and external-facing activities that support a shift to a higher-touch, patient-centric focus, The Clinical Solutions Medical Director CMO will develop, implement, support, and promote population health strategies, tactics, policies, and programs that drive the delivery of high value healthcare to establish a sustainable competitive business advantage for Aetna. 5. These strategies, policies, and programs are comprised of care management, utilization management, quality improvement, network management as well as clinical coverage protocol.6. The CMO will be provider and patient facing.7. The CMO will have fluency in data analytics.Pay RangeThe typical pay range for this role is:Minimum: 162,600Maximum: 348,000Please 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 Graduate of an American or Canadian medical school accredited by the Accreditation Council for Medical Education (ACME) or equivalent training in a foreign medical school with successful completion of the ECFMG and FLEX examinations. Unrestricted current and valid license or certification to practice medicine in a state or territory of the United States. Full training in a residency program in the United States or Canada that is approved by the ACGME. Post-residency experience of at least 5 years involving substantial direct patient care during this period at multiple levels of care. Clinical experience pertinent to the patient population(s) being managed, specifically complex populations, Medicaid and/ or Medicare. Utilization Review and Care Management experience required. Managed care experience required, as provider and / or manager of care.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 QualificationsKnowledge of: Industry and scientific focus in improving the health of communities.Skill in: Medicaid, Population health strategiesEducationDoctorate of Medicine, and eitherOther Certification(s): DO - Physician, State Licensure and Board Certified (ABMS or Specialty Board) - Physician MD - Physician, State Licensure and Board Certified (ABMS or Specialty Board) - PhysicianBusiness 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.
Job Title
Sr Clinical Solutions MD (CMO Aetna Better Health)