Executive Medical Director, Medical Affairs

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.

Position Overview

Quality is part of Aetna’s DNA. We are committed to ensuring that every MD decision reflects sound clinical judgment, consistent application of evidence-based criteria, and an unwavering focus on doing what is best for our members. To strengthen and scale this commitment, Aetna Medical Affairs is establishing a centralized MD Quality function to oversee and ensure the quality of MD decisions across lines of business. This team will ensure rigor, consistency, transparency, and accountability in MD review processes – reinforcing our strong track record while evolving our oversight model to meet the demands of a complex and highly regulated environment.

The Executive MD Quality Lead will lead this function, serving as the clinical authority responsible for shaping the future state MD Quality operating model. This role will advance review methodology, performance calibration, and governance to ensure MD decisions remain clinically sound and aligned with enterprise standards and member-first principles.

Key Responsibilities

• Oversee governance of Aetna’s centralized MD Quality function, ensuring alignment with enterprise standards and regulatory requirements
• Lead a multidisciplinary team (Clinical and Admin Auditors, Trainers, Data Analyst, and Program Ops Manager) to strengthen audit rigor and consistency in MD reviews
• Analyze decision trends and variability to ID high-impact areas for targeted improvement
• Evaluate audit methodologies and insights to ensure findings are actionable, defensi