Medical Director of Clinical Informatics

CVS Health • North Carolina, North Carolina • 18h ago

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.

We're building a more connected, convenient, and compassionate health experience.

The Medical Director of Informatics is a clinical leader who supports clinical analytics and clinical informatics needs within PBM product and CVS Healthspire Payor Solutions across multiple care management and digital health products. The organization designs, delivers, and operates a configurable collection of products and tools that complement the benefit plans of our employer and health plan customers. Our care delivery and care management solutions target population health outcomes that require risk mitigation, intervention, and ongoing chronic care management. We use technology-enabled population identification based on multisource data integration - medical claims, pharmacy claims, lab data and patient inputs- for applying evidence-based opportunities and an omnichannel, next best action approach.

This role partners with Product, Technology, Data/Analytics, and Clinical Governance stakeholders to ensure that clinical guidance and analytic insights are evidence-based, scalable, and operationalized through clear clinical requirements, robust measurement, and disciplined content/logic governance. This is not a utilization management or direct patient care delivery role; it is a product- and data-facing physician leadership role focused on clinical informatics, analytics oversight, and clinical governance.

Primary Responsibilities

Serve as the clinical informatics subject matter expert for product teams by translating clinical concepts and evidence into implementable requirements (e.g., clinical definitions, decision logic, care pathway content, and data requirements).

Establish and maintain clinical data definitions and clinical "north star" measures (outcomes, quality, safety) used across products-ensuring consistency across teams and releases.

Review and approve clinical-facing content and logic for accuracy, safety, and evidence alignment (including change control, documentation, and auditability).

Partner with Data/Analytics and Data Science teams to define analytical approaches that support strategic initiatives, trend detection, and measurable product impact (quality, outcomes, engagement, experience, and cost-related measures as appropriate).

Support development of evidence generation outputs including white papers and manuscripts through direct statistical analysis and writing.

Ensure analytics and clinical logic are clinically interpretable and responsibly communicated to stakeholders (clear caveats, intended use, limitations, and appropriate escalation guidance).

Required Qualifications

Current Board Certification in Clinical Informatics

Active, unrestricted medical license (state unspecified) with ability to obtain additional licensure if required by business needs.

At least 2 years of demonstrated clinical informatics experience (e.g., building/operationalizing clinical decision logic, clinical data definitions, clinical content governance, interoperability-informed workflows, or related informatics leadership).

At least 2 years of experience analyzing claims data through SQL.

Candidate must be willing to work Eastern Time Zone business hours.

Preferred Qualifications

Experience in payor, population health, or enterprise care management environments (health plan and/or health system).

Experience with outcomes measurement frameworks, clinical quality measurement, and population health program evaluation.

Prior experience with SQL/R/Python and causal inference techniques.

Prior experience developing white papers or publications.

Education

M.D. or D.O. required.

Pay Range

The typical pay range for this role is:

$174,070.00 - $374,920.00

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. This position also includes an award target in the company's equity award program.

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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments (https://learn.bswift.com/cvshealth-mainland) .

We anticipate the application window for this opening will close on: 05/22/2026

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

CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran - committed to diversity in the workplace.

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