Lead Senior Medical Director

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. **\*\*\* This is a fully remote, full\-time position requiring availability Monday through Friday, 8:00 a.m. to 5:00 p.m. Eastern Time. \*\*\*** **Position Summary:** Under the leadership and direction of the Executive Medical Director for Duals, the Lead Senior Medical Director provides strategic leadership and clinical oversight for complex populations—primarily DSNP/FIDE—and is responsible for leading a team of Senior Medical Directors/Medical Directors within the Center of Excellence (COE) Duals. This role drives medical management programs and policies that improve quality, cost, and outcomes across the continuum of care; integrates medical, behavioral, and social drivers of health; serves as a clinical and business liaison to internal teams, network providers, and state agencies; and ensures compliance, operational excellence, and superior member experience. **Key Responsibilities:** **Leadership \& Team Management** * Lead, coach, and develop a team of Senior Medical Directors; foster collaboration among peers * Manage coverage schedules, vacations, team assignments, and change management. * Provide ongoing coaching and feedback to ensure peak performance; build a culture of continuous improvement and integrity * Development of “How” to solve the problem * Actively participate in scheduled team and leadership meetings at health plan, local, state, regional, and national levels supporting the EMD. * Strategy involvement, supporting goal setting, clinical leadership **Clinical Oversight for DSNP/FIDE \& Complex Populations** * Responsible for clinical oversight of DSNP/FIDE complex populations. * Develop and lead clinical strategy and objectives for DSNP/FIDE, including clinical initiatives/programs to improve outcomes. * Facilitate/Improve interdisciplinary care team rounds for DSNP/FIDE members * Confer directly with CMOs/SMDs/MDs regarding care of patients with severe, complex, and/or treatment\-resistant illnesses through peer review and educational interventions. **Medical Management, Quality \& Programs** * Ensure compliance with clinical goals by monitoring care management performance; expand medical management programs to address member needs. * Assists to develop, implement, and interpret medical policy, including medical necessity criteria, clinical practice guidelines, and new technology assessments. * Develop and guide implementation of programs ensuring providers deliver appropriate, high\-quality, cost\-effective health risk assessments (HRAs) and other evidence\-based serv