Description

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.

*This position is fully remote, Qualified candidates can live anywhere in the contiguous United States*

Position Summary

The Clinical Innovation Lead Director is a critical leader responsible for managing and successfully driving the clinical innovation initiatives that solves key business problems and creates new sources of value for Utilization Management within Aetna's Clinical Solutions business unit. This role leads the planning, execution, and delivery of complex high-impact initiative aligned to corporate goals, regulatory requirements and clinical best practices. The ideal candidate will have deep domain expertise in health insurance, strong portfolio management skills, and a proven track record of delivering large-scale, customer-facing innovative solutions.

• Lead innovation initiatives to modernize healthcare UM operations by aligning cross‑functional teams, advancing strategic priorities, and driving continuous improvement.
• Lead and manage strategic projects and programs from initiation to completion, ensuring on-time delivery, budget adherence, and alignment with defined scope and objectives.
• Oversee end to end solution delivery, including concept design, proof of value evaluation, pilot execution, scaled readiness, and ongoing value realization and performance monitoring.
• Develop and manage interventions, facilitate collaborative working sessions to support adoption and continuous improvement, and deliver high quality analysis, reporting, and presentation materials.
• Collaborate with senior leadership to define strategic plans, establish program objectives, and ensure alignment with organizational priorities

• Apply formal project management methodologies to manage timelines, risks, dependencies, and change controls; maintain detailed documentation, dashboards, and executive-level reporting.
• Monitor budgets and resource allocation to ensure financial accountability and maximize ROI; proactively develop mitigation strategies and contingency plans to address risks
• Responsible for developing, motivating and managing a high-performing team members to meet organizational goals and objectives while effectively managing change.
• Contribute to a motivated work environment by working collaboratively and effectively with key stakeholders across Health Care Business and Aetna Clinical Solutions to achieve common goals.

Required Qualifications

• 10+ years' experience in healthcare project management with proven track record of leading large-scale, complex initiatives in healthcare insurance or managed care organization
• Strong understanding within clinical and health plan operations and value creation methodologies including Utilization and Policy Management, Care Management and Coordination, Quality, Compliance and Regulatory Management
• Successful experience in strategic planning, execution, and agile project portfolio management within healthcare industry
• Strong data and analytics skills to include modeling, synthesizing information and deriving key insights.
• Expertise in technologies such as APIs, Microservices, Business Rules, Predictive Modeling, AI, NLP.
• High ability to consistently produce and create value and meet/exceed committed performance
• Strong interpersonal and communication skills, effectively communicate key messages to executive leaders and internal/external stake holders.
• Strong verbal and written communication skills; proven ability to deliver presentations to senior leadership team members
• Effectively lead and motivate teams to ensure high standards of performance and outcomes

Preferred Qualifications

• 5+ years with demonstrated leadership and experience with the following: Innovation, advanced analytics, generative AI, business process optimization, enterprise business portfolio management/consulting, financial analysis, mergers and acquisitions, strategic planning, risk management
• Health domain certifications such as AHIP certifications (Fundamentals of Healthcare Part A & B, AHM250).
• Demonstrated relationship management skills at the senior level; capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously.
• Experience creating new capabilities and/or project offerings that result in new value; conceptual and structured thinker that has a high degree to generate and translate concepts and ideas into effective strategies that achieve results
• Ability to manage and grow a team of individuals to achieve departmental goals at a rapid pace
• Ability to embrace change, uncertainly and shifting priorities and plans to accommodate broader changing objectives and demands

Education

Bachelor's Degree Required

Master's Degree preferred

Pay Range

The typical pay range for this role is:

$100,000.00 - $231,540.00

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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 06/05/2026

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