VP, Chief Medical Officer - Value Care

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.

Aetna is seeking to hire a VP & Chief Medical Officer of High Value Care. This Medical Director role will report directly to Aetna’s Senior Vice President & Chief Medical Officer. The incumbent will serve as the Medical Affairs lead for all levers focused on reducing total cost of care while maintaining and improving care quality, in close collaboration with Aetna senior leadership and business strategy.

The role will be accountable for meeting short- and long-term medical cost savings targets to ensure business sustainability and market differentiation, ensuring clinical quality and reliability, and driving cost efficiencies while ensuring high quality care to our members. This work will include partnering with business segment leaders to drive clinical programs which maximize affordability and quality of care for our members.

• Leads organizational efforts to develop long range clinical strategy and roadmap, in alignment with business objectives related to cost of care, quality, and provider and member experience.
• Responsible for Aetna-wide clinical leadership and governance for all levers focused on reducing total cost of care while maintaining/improving care quality, including: care models, vendor partnerships, value-based arrangements.
• Partners closely with business leadership to set and achieve performance targets (PMPM, admissions/1,000, ED/1,000, MLR), and develops synthesized view and strategy with CMOs for UM, Network, as well as LOB CMOs.
• Particular focus on priorities and trends in the Medicare market, in alignment with line of business leadership, client needs, and industry dynamics.
• Ensures cross-functional operational excellence through deep payer experience, focused on delivering measurable results across Medicare, Commercial, and Medicaid.
• Responsible for monitoring trends, developing actionable clinical insights, creating integrated views of clinical opportunities and performance across lines of business and functions, proactively driving performance.
• Partners with business leadership to continually prioritize and respond to emerging industry trends, legislation, and other challenges which impose risk to the business.
• Drives accountability and achievement across clinical leaders and functions responsible for provider network strategy and engagement, clinical program development and execution, and specialty care strategy and SME teams.
• Develops best-in‑class, innovative clinical programs, policies, and partnerships to improve health outcomes, affordability, and experience of care for members.
• Collaborates with cross-enterprise partners, providers, and vendors to position Aetna as an industry leader in technology-enabled capabilities and solutions (e.g., AI, virtual).
• Drives long‑term success of partnerships and programs, evaluates clinical and business impact, and scales successful strategies.

• 15+ years of experience in clinical practice, healthcare management, or a related field, with at least 5 years in a leadership role focused on clinical strategy and innovation.
• Strong understanding of healthcare regulations, value‑based care models, and population health management.
• Proven track record of successfully leading clinical initiatives that drive cost savings and improve quality of care.
• Exceptional leadership, communication, and interpersonal skills, with the ability to influence and engage stakeholders at all levels.
• 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.

• Near Hartford, CT or Wellesley, MA (preferred)
• Ability to work Hybrid Model in office Tuesday /…