Executive Medical Director, Medical Affairs
Core
Lead a centralized Medical Director (MD) Quality function to ensure clinical rigor, consistency, and accountability in MD decisions across Aetna's lines of business.
Role type
Executive Medical Director (Quality Lead)
Builds
Centralized MD Quality operating model and governance frameworks
Domain
Health Insurance / Utilization Management / Clinical Quality
Required skills
Clinical leadership, utilization management, medical policy, quality oversight, performance calibration, regulatory standards (CMS, NCQA), audit methodology, data analysis, executive communication
Preferred skills
Change management, enterprise-wide quality improvement, IRR methodology, multi-line business experience
Technologies
None stated
Responsibilities
Oversee governance of the centralized MD Quality function; Lead a multidisciplinary team to strengthen audit rigor; Analyze decision trends to identify improvement areas; Evaluate audit methodologies; Lead MD Quality forums; Prioritize quality improvement interventions; Track quality metrics; Represent MD Quality in executive forums; Partner with ACS for cross-functional alignment
Seniority
Executive, strategic leadership
