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CVS Health

Bringing our heart to every moment of your health.

VP, Chief Operating Officer, Medical Affairs

Chief Operating OfficerChief Operating OfficerFull TimeRemoteLeadTeam 10,001+Since 1963H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

4 days ago

Salary

$250K - $350K / year

Seniority

Lead

No structured requirement data.

Job Description

VP, Chief Operating Officer, Medical Affairs

CVS Health

Role Description Aetna is seeking to hire a VP, Chief Operating Officer for Medical Affairs with deep experience in enterprise-level clinical operations. Reporting directly to Aetna’s Senior Vice President & Chief Medical Officer, this senior executive will serve as the primary operational leader overseeing all core Aetna Medical Affairs functions, including: - Utilization management - Appeals - Care management - Care model design - Clinical pathways - Network/Provider Engagement - Clinical enablement programs The VP, COO for Medical Affairs will act as a strategic partner to the CMO- VPs for Commercial, Medicare, and Medicaid as well as to the VP of Utilization Management, ensuring alignment between line-of-business strategies and Medical Affairs operations. This leader will also serve as the principal operational interface with ACS and Network leadership, ensuring cross-functional integration, operational readiness, and consistent national execution. The successful candidate will bring an enterprise mindset and the ability to build a unified operating model across Aetna Medical Affairs, including: - Developing consistent national processes - Ensuring compliance and performance - Advancing technology-enabled operations - Driving scalable, measurable improvements in quality, efficiency, and member and provider experience Qualifications - 15+ years of progressive experience and responsibility at a senior leadership level in managed healthcare operations, compliance, or related field. - Deep understanding of utilization management and its impact on healthcare quality and total cost of care. - Deep understanding of clinical/claims systems and processes related to member support services, payment integrity, and other connected processes. - Deep understanding of compliance and quality programs (e.g., NCQA, HEDIS). - Experience in addressing issues impacting member and provider experience. - Demonstrated ability to work collaboratively across functions to align on shared goals, integrated processes, and KPIs. - Demonstrated leadership with relevant initiatives: business process optimization, cross-functional integration, strategic operational planning, risk management. - Proven ability to leverage understanding of the emerging healthcare environment to create the platform for change and meet demands for evolving operational needs. - Demonstrated ability to lead and influence cross-functionally, organize and integrate strategies, and align stakeholders on priorities and deadlines. - Strong analytical and problem-solving skills, with a data-driven approach to decision-making. - Ability to thrive in a fast-paced, dynamic environment and manage multiple priorities effectively. Requirements - Degree, certification, or equivalent experience related to healthcare or health plan operational management. - Advanced degree in healthcare administration or business administration is a plus. Benefits - Comprehensive medical, dental, and vision coverage - Paid time off - Retirement savings options - Wellness programs - Other resources, based on eligibility Pay Range The typical pay range for this role is: $250,000-$350,000. This 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.

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