Description

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

Excellent opportunity for an experienced clinician with a passion for consulting and improving overall population health to leverage clinical, analytic, and consultative skills to join our team of Clinical Program Consultants (CPCs) who offer clinical insights and solutions to help improve health plan performance for our group commercial plan sponsors.

Highly collaborative, strong individual contributor position in a professional environment working with the co-branded solutions team, for this dedicated customer, Aetna's clinical operation teams and our Plan Sponsor Insights team of consultants.

The components of the role include:

• Provide clinical consultation based on analysis and identification of key drivers of results e.g., use data to identify clinical trends. Aligns clinical programs with customer strategy, evaluates performance results, monitors engagement, and proactively identifies opportunities for improvement.
• Recommend clinical programs, services and plan design changes that align with the customer's population health strategy and help drive short- and long-term results e.g., assisting with development of health strategies, tactics, policies, and programs (which could include network management, clinical coverage, care management, and compliance policies for data and information) that improve overall population health and encourage efficient and effective delivery of benefits.
• Perform independent development and presentation of clinical content with recommendations in customer-facing meetings e.g., present findings and recommended actions to help improve performance and clinical outcomes, working collaboratively to help track and resolve issues.
• Research and evaluate programs and processes to identify savings and efficiency opportunities that may result in policy and procedure changes that impact the customer and the enterprise
• Act as a trusted clinical resource providing clinical program guidance
• Collaborate across the enterprise and with clinical operations to optimize collaboration, efficiency, and impact
• Provide input to the design of clinical solutions and workflows leveraging knowledge of workflow, policy, and procedures to help ensure teams can work collaboratively
• Stay current on, and share knowledge of population health trends
• Provide coaching, direction, feedback, and support of other matrixed team members including external vendors to drive integrated value for the plan sponsor
• This is a customer-facing role with the potential for travel to meet with customers and review plan performance, discuss recommendations, etc., as determined by the customer.

Clinical Program Consultants are key members of Aetna's business focused on providing insights and solutions based on analytics to customers in the group commercial business. The work environment supports and thrives on the ability to create and present reports to diverse audiences and manage multiple deadlines in a fast-paced environment. We encourage an out-of-the box mindset, creative talent, and a consultative approach. Our team is highly valued by our internal partners as well as the customers we serve.

Location: One may live anywhere in the United states, but must be willing to work Eastern Time Zone hours

Required Qualifications

• 7+ years experience (may be a combination of different sites of care practice including: hospital, clinic, and/or community health) with a strong understanding of clinical decision support platforms (e.g., ATV, MedCompass, NovaLogic), EMR, and other technologies and data sources used within a healthcare delivery system
• Experience with enterprise-wide and/or cross-functional large-scale initiatives with high degree of complexity.
• 7+ years of experience in, and knowledge of, the healthcare industry and market.
• 5+ years of Healthcare Consultation Experience working with External Constituents
• Strong clinical analytic skills and demonstrated conceptual thinking
• 5+ years leadership experience
• 3+ years of utilizing Excel and other reporting mechanisms to support analysis.
• Ability to travel to visit customers 6-8 times/year

Preferred Qualifications

• Registered Nurse with unrestrictic license in state of residence
• Experience working with a Health Insurance Carrier
• Strong problem-solving skills and attention to detail
• Excellent consultative, communication and presentation skills (ability to take complex content and facilitate understanding for the audience including preparing and presenting effective and compelling power point slides)
• Demonstrated relationship management skills at the senior level; capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously.
• Experience with workflow development/process design
• Comfortable with organizing and responding to multiple deliverables in a timely and professional manner
• Designs, develops interventions, and facilitates work sessions. Develops and delivers all required analysis, reporting and presentation materials

Education

Bachelor's degree or equivalent experience

Pay Range

The typical pay range for this role is:

$82,940.00 - $182,549.00

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.

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 people

We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 11/26/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.