Medical Director (Aetna One Advocate)

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

Ready to take your Medical Director skills to the next level with a Fortune 5 company? Check out this opportunity with Aetna, a CVS Health company!

This is a remote based work from home role.

The Aetna One Advocate model provides the member with a powerful and proactive experience through high touch, personalized communications designed to help the member achieve their health ambition.

Some key daily activities :

• Partner with other Advocate team members to holistically assess member’s needs
• Collaborate with treating providers through personalized, creative solutions to help member’s meet their health care needs.
• Lead the clinical staff in the coordination of quality care on behalf of members
• Conduct educational and clinical rounds with A1A clinical staff
• Provide clinical expertise and business direction in support of medical management and utilization review programs through participation in clinical team activities including precertification, concurrent review / discharge planning, case management, disease management and quality management
• Provide clinical guidance in promoting member quality of care and reviewing / addressing potential lapses
• Act to engage providers and facilities in improving the quality of care delivered to our members and assure that our shared relationships are maintained and improved
• Proactively use data analysis and periodic assessments to identify opportunities for quality improvement
• Work collaboratively with other functional areas that interface with medical management including provider relations, sales, benefits, healthcare delivery, national medical services and national accounts to achieve the business goals

Required Qualifications

Preferred Qualifications

Please replace this section with the Preferred Job Qualifications

Education

Pay Range

The typical pay range for this role is :

$174,070.00 - $374,920.00

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

We anticipate the application window for this opening will close on : 12 / 15 / 2025

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