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Position Summary
At Aetna, our health benefits business, we are committed to helping our members achieve their best health in an affordable, convenient, and comprehensive manner. Combining the assets of our health insurance products and services with CVS Health’s unrivaled presence in local communities and their pharmacy benefits management capabilities, we’re joining members on their path to better health and transforming the health care landscape in new and exciting ways every day.
Aetna is seeking an Executive Director, Clinical Health Services to lead the Mental Well-being team. This role will guide strategy and operations using mental health expertise, data, and research to deliver actionable insights that improve outcomes and manage costs. This is an individual contributor position responsible for collaborating across multiple functions within the organization to drive key initiatives.
Major Responsibilities
Support sales teams in finalist presentations by addressing clinical questions and explaining the care model.
Collaborate with Clinical Operations (Employee Assistance Programs, Resources for Living, and On-Demand teams) and the Office of Health Care Affordability (OHCA) to advance affordability initiatives and adhere to specific, measurable actions tied to performance goals or compliance standards that are evaluated and scored (SAIs).
Analyze cost trends and work with network teams, Special Investigations Units, and other stakeholders to reduce costs and improve outcomes.
Represent Aetna Mental Well-being at industry events, presenting analytics, clinical insights, and thought leadership on mental health and overall well-being.
Partner with Aetna’s Performance Excellence Quality (PEQ) team to guide analytics design, interpret results, and present outcomes data to customers and industry leaders.
Ensure efficient, effective delivery of healthcare services in collaboration with clinical operations.
Work with senior clinical leadership, including the Chief Psychiatric Officer and Chief Medical Officer, to maintain clinical standards and policies.
Develop strategies to improve member access, care quality, and affordability.
Provide mental health expertise for HEDIS and NCQA initiatives in partnership with Quality teams.
Offer clinical input for evaluating mental well-being vendors.
Contribute to research and publications, supporting peer-reviewed submissions and initiatives to improve quality and total cost of care.
Required Qualifications
The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to all aspects of the company’s business, as well as significant interaction with all the business leaders. The candidate will be expected to have the following key attributes:
10-15 years of population health experience including Total Cost of Care analysis, clinical strategy, clinical operations leadership, and value-based behavioral health initiatives.
10+ years of experience working with behavioral health products.
Strong ability to interpret analytics, guide data design, and present outcomes to internal and external stakeholders.
Experience partnering with sales teams on finalist presentations, providing clinical expertise and addressing customer questions.
Proven experience collaborating with senior clinical leadership to maintain standards and policies.
Demonstrated success in developing strategies that improve access, quality, and affordability of care.
Knowledge of HEDIS and NCQA quality measures with experience applying mental health expertise to these initiatives.
Skilled in influencing senior leaders, building consensus, and driving strategic initiatives in complex, matrixed organizations.
Experienced public speaker with direct engagement across customers, business leaders, and industry forums.
Ability to evaluate mental well-being vendors and contribute to research and peer-reviewed publications.
Strong project management capabilities, including financial, analytical, planning, and implementation.
Understanding of clinical guidelines, best practices and the latest on evidence-based care.
Education
Clinical Licensure (LCSW, MD, MSW, PhD, PsyD or DBH) required.
Pay Range
The typical pay range for this role is:
$184,112.00 - $396,550.00
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.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.