Executive Medical Director, Clinical Business Solutions

This is a fully remote position, open to applicants in Connecticut.

📋 Description

• Lead, mentor, and nurture a national team of clinicians within the National Accounts, Large Group, and Public & Labor segments.

• Build and maintain relationships with brokers, consultants, and plan sponsors.

• Direct clinical sales initiatives for prominent prospects.

• Enhance team operations, coverage strategies, prioritization, preparation, and materials.

• Establish the team coverage model and distribute clinical capacity based on pipeline value, retention risk, and strategic significance.

• Set benchmarks for clinical narratives, presentation materials, and meeting preparations.

• Oversee hiring, onboarding, performance management, development planning, and succession strategies.

• Act as the senior clinical authority during finalist meetings, RFP responses, and clinical strategy discussions.

• Create strategic clinical messaging and communicate Aetna’s clinical differentiation effectively.

• Keep Field teams informed about Aetna’s clinical programs through briefings and training sessions.

• Convert Aetna’s clinical program portfolio into tailored value narratives for prospects.

• Promote retention and growth through strategic client reviews, clinical roadmaps, and discussions on outcomes and affordability.

• Analyze client-specific utilization, cost, and quality data to recommend clinical program initiatives.

• Manage engagement with producer representatives from benefits consulting firms, brokers, and general agents.

• Lead clinical responses to consultant surveys, market analyses, and program and vendor evaluations.

• Represent Aetna at consultant forums, market events, industry conferences, and employer coalitions.

• Gather and channel feedback from customers, producers, and Field into product and clinical roadmaps.

• Identify competitive gaps and emerging requirements from plan sponsors.

• Maintain a thorough understanding of Commercial market dynamics, competitor strategies, health policy, and clinical program landscapes.

• Represent Commercial Medical Affairs in governance forums and cross-functional teams.

• Ensure that clinical claims presented externally are evidence-based, accurate, and defensible.

⛳️ Requirements

• MD (Doctor of Medicine) or DO (Doctor of Osteopathic Medicine) degree.

• Active and current medical license (MD or DO) without any encumbrances in at least one U.S. state.

• A minimum of 8 years of experience post-training in Commercial health insurance, managed care, benefits consulting, or a medical management organization.

• Proven experience in an external, client-facing role.

• Extensive understanding of employer-sponsored Commercial health insurance, covering funding arrangements, benefit design, utilization management, care management, network, and pharmacy integration.

• Ability to transform clinical and claims data into a coherent business narrative for non-clinical executive audiences.

• Outstanding executive presence and platform skills.

• Capability to establish credibility and cultivate lasting relationships with sophisticated external buyers and intermediaries.

• Experience in leading, coaching, or formally mentoring clinical colleagues.

• Exceptional stakeholder management abilities and capacity to form coalitions across diverse, matrixed internal teams.

• Willingness to travel approximately 25–50% for client, producer, and Field meetings.

• Preferred: Established connections within the national benefits consulting and broker community or with large self-insured employers.

• Preferred: Previous formal responsibility for named consultant, broker, or general agent relationships.

• Preferred: Direct experience in people leadership over a clinical team.

• Preferred: Background in National Accounts, Large Group, and/or Public & Labor segments.

• Preferred: Externally facing experience at a national health plan, benefits consultancy, health services company, or point solution marketing to employer groups or large self-insured employers.

• Preferred: Knowledge of pharmacy benefit design, specialty drug trends, and integrated medical-pharmacy value narratives.

• Preferred: Proven track record of external thought leadership.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program.

• Equity award program.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources supporting physical, emotional, and financial well-being.