Employer Active
Job Alert
You will be updated with latest job alerts via emailJob Alert
You will be updated with latest job alerts via emailNot Disclosed
Salary Not Disclosed
1 Vacancy
* Flexible Onsite Location: Willing to consider other onsite locations.
OVERVIEW/DESCRIPTION:
As a member of the Cigna Healthcare (CHC) Clinical Leadership team this role will report directly to the Chief Medical Officer (CMO) for Cigna Healthcare and will be responsible for leading CHC Clinicals ValueBased Care (VBC) Trend and Network Management team in support of driving Total Cost of Care (TCOC) performance improving clinical outcomes and advancing Cignas VBC strategy. This role will focus on the ultimate goals of driving improved patient care payment model innovation enhanced provider performance and stronger provider relations and solidifying network alignment through datadriven solutions and strategic collaborations.
The successful candidate for this role will be a physician leader with extensive valuebased care experience and a strong understanding of the clinical levers that impact the quality and cost of care. This leader will develop and execute a visionary strategy for advancing our collaborative/accountable care models and alternative payment models (APMs) and will oversee efforts to expand riskbased contracts to deepen our alignment with provider partners. This leader will oversee network and provider relationships through creating and leading an enhanced provider relations team. This role will be jointly accountable for the organizations total cost of care initiatives partnering closely with financial network and product teams to identify and activate clinical levers that drive performance and outcomes. This role will require a growthoriented motivational and collaborative mindset capable of building strong relationships and partnerships at all levels of the organization.
RESPONSIBILITIES:
Advance Our VBC Strategy: Advance Cignas existing alternative payment model strategy; this may involve creating new structures or partnering with innovative valuebased care stakeholders to move the organization closer to payor/provider alignment. Grow capitated lives and advance innovation in network strategy including through alternative network models centers of excellence and enhanced gold carding initiatives.
Drive Clinical & Financial Integration and Action:Partner with financial teams to identify and understand TCOC drivers and to translate insights into clinical actions to improve and coordinate care.
Enhance Provider Network Management:Establish and lead a regionallyoriented team of dedicated Medical Executives and Nurse Executives to manage provider performance and network management.
Bolster Provider Relations:Partner with the provider services team to bolster providers experiences of working with Cigna through structured interventions and handson relationship management.
Drive CrossFunctional Collaboration:Develop a crossclinical brain trust team to provide structured insights to actuarial and underwriting partners informed by anticipated clinical trends and innovations.
Lead and Develop Teams: Build and manage highperforming teams comprised of medical executives nurse executives operators and subject matter experts specializing in valuebased care clinical trend and network strategy.
Ensure Operational and Performance Measurement:Implement scalable processes to enhance VBC adoption track performance outcomes and adjust strategy based on realtime data insights. Define and track key performance indicators (KPIs) to assess the impact of VBC strategies ensuring continuous improvement and market competitiveness.
Recruit a talented bench: Staff with toplevel talent bringing bestinclass internal clinical strategy and operations talent together alongside external talent with new and innovative perspectives.
Achieve a clinical/business balance:Be respected organizationwide as being staffed with clinicians who bring both clinical expertise patientfocused integrity and compassion and a sharp business and P&L mindset.
Be resultsoriented:Be oriented to managing work from vision through to completion with a quantitative orientation and an ability to get stuff done.
Work effectively within a matrix: Navigate complex crossmatrix working relationships and dynamics with ease and an ability to successfully drive work through collaboration and influence.
REQUIRED SKILLS:
MD/DO degree required; MBA and/or relevant business experience 1015 years) preferred.
Minimum of 10 years of experience in healthcare leadership valuebased care strategy and provider network management.
Minimum of 5 years of experience in clinical practice. Current clinical practice is a plus but not required.
Strong understanding of healthcare financial modeling trend analysis and clinical performance improvement.
Exceptional leadership and relationshipbuilding skills with the ability to drive alignment across diverse teams.
Experience working with actuarial and finance teams to measure VBC success and optimize network performance.
Ability to thrive in a complex matrixed environment and manage multiple strategic initiatives simultaneously and with proven ability to develop internal enterprise relationships and influence partners.
Experience demonstrating iterative and synergistic solutions with nearterm value delivery in service of longerterm pivots.
Experience with Commercial health plan product constructs design and innovative benefit structures.
Demonstrated ability to deliver creative solutions to complex challenges.
Strong communication skills particularly the ability to translate complex topics into consumable formats.
Willingness to travel as needed to support provider and regional team engagement.
About The Cigna Group
Doing something meaningful starts with a simple decision a commitment to changing lives. At The Cigna Group were dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services we are committed to enhancing the lives of our clients customers and patients. Join us in driving growth and improving lives.Qualified applicants will be considered without regard to race color age disability sex childbirth (including pregnancy) or related medical conditions including but not limited to lactation sexual orientation gender identity or expression veteran or military status religion national origin ancestry marital or familial status genetic information status with regard to public assistance citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process please email: for support. Do not email for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobaccofree policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama Alaska Arizona Arkansas Delaware Florida Georgia Hawaii Idaho Iowa Kansas Maryland Massachusetts Michigan Nebraska Ohio Pennsylvania Texas Utah Vermont and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal state and local ordinances.
Required Experience:
Chief
Full-Time