Aetna Commercial Clinical Program Consultant – Eastern US Region

About the position 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.

Responsibilities

• 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.

Requirements

• 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

Nice-to-haves

• 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
• RN – BSN preferred or equivalent experience

Benefits

• 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.

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