Aetna Commercial Clinical Program Consultant – Eastern US Region

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

Exciting opportunity with Aetna's Regional Clinical Consulting team for an experienced clinician with an intellectual curiosity, desire for continuous learning and passion to improve population health.  Clinical Program Consultant (CPC) plays a key role in delivering strategic clinical insights to commercial plan sponsors in the Eastern US by combining clinical expertise, data analysis, and consultative communication.

As a CPC, you will collaborate closely with account teams, care management, Regional Analytic Consulting, and key enterprise partners to support customer objectives. You will help customers understand plan performance, identify improvement opportunities, and implement solutions that drive better health outcomes and cost efficiencies.

Key Responsibilities

In this role, you will be empowered to:

• Deliver forward-thinking clinical insights derived from analyzing clinical utilization patterns and member behavior impact on medical costs.
• Recommend clinical programs and services aligned with customer strategy to influence short‑ and long‑term results.
• Analyze, synthesize, and present clinical findings paired with actionable recommendations in customer‑facing meetings.
• Serve as a trusted clinical resource on population health, industry trends, and health disparities.
• Collaborate across the organization to align strategies between customers and the health plan.
• Contribute to customer population health strategies across the clinical continuum.
• Create and propose solutions to improve member health, including leveraging community resources and partnerships in the Eastern region.

This is a customer‑facing role requiring up to 50% travel throughout the Eastern U.S., including onsite customer meetings, plan‑performance discussions, and strategic consultations.

This is a work‑from‑home position.  Preference will be given to candidates residing in the Eastern United States and within approximately two hours of a major Eastern-region airport (e.g., Atlanta, Charlotte, Miami, Orlando, Tampa, Washington Dulles, Reagan National, Baltimore, Philadelphia, Newark, New York–JFK, New York–LaGuardia, Boston).

Clinical Program Consultants are key contributors to the Regional Clinical Consulting business—a multidisciplinary team of physicians, nurses, clinical social workers, well‑being consultants, and analytic consultants. Our environment values creativity, collaboration, and a consultative mindset, and our support is highly valued by internal partners and customers.

Required Qualifications

• Active, unrestricted registered nurse (RN) license
• Minimum 5 years of clinical experience
  • At least 3 years in acute care
  • Remaining experience may include hospital, clinic, or community health
• 1+ years of healthcare consultation experience with external stakeholders
• Ability to travel up to 50% within the Eastern U.S.
• Highly proficient with MS Office programs (Excel, PowerPoint, Word, and Outlook)
• Excellent consultative, communication and presentation skills (especially PowerPoint)
• Excellent problem‑solving skills and attention to detail
• Strong clinical analytics skills, including Excel and reporting tools
• Effective presentation skills and experience communicating with large groups
• Proficient consultative, communication, and relationship‑building skills, including at the executive level
• Ability to manage multiple deliverables in a timely and professional manner
• Proficiency with MS Office Suite

Preferred Qualifications

• 1+ years of leadership experience
• Experience working with a health insurance carrier
• Familiarity with benefit plan design
• Strong ability to communicate chronic condition impacts on population health

Education

• RN – BSN preferred or equivalent experience

Anticipated Weekly Hours

Time Type

Pay Range

The typical pay range for this role is:

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. 
 

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 https://jobs.cvshealth.com/us/en/benefits

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