Position Summary

The Director of ValueBased Care Performance and Provider & Network Experience is a senior clinical performance leadership role accountable for executing measuring and continuously improving clinical programs that drive patient outcomes provider experience and total cost of care. This role requires strong analytical and actuarial fluency applied to clinical decisionmaking outcome measurement and performance accountability. The Director ensures that clinical initiatives are supported by clear measurement frameworks and financially sound business planning; that outcomes are rigorously defined evaluated and reported; that findings are translated into actionable program refinements and operational improvements; and that results are distilled and disseminated to key internal and external audiences.

Working closely with clinical executives in the markets provider organizations and enterprise partners the Director ensures that ValueBased Care Network and Provider Experience initiatives are clinically credible operationally effective and financially sustainable. The role maintains primary accountability for clinical performance improvement and affordability impact and reporting.

Key Responsibilities

Provider Experience and Measurement

• Support the execution and ongoing management of provider experience improvement initiatives with ownership of outcome measurement and performance tracking
• Develop and maintain provider experience measurement frameworks and partner with providers to interpret results and implement targeted improvement actions
• Ensure providerfacing reporting and performance tools are clinically meaningful and aligned with care delivery workflows
• Maintain and oversee clinical scorecards (and other ad hoc business reporting needs) related to provider experience access and care delivery performance ensuring measures support accountability and improvement

Value-Based Care and Network Performance

• Maintain operational responsibility for defining and measuring clinical performance outcomes and affordability impact across valuebased care and network clinical programs
• Apply actuarial financial and clinical effectiveness analyses to evaluate clinical intervention performance provider economic opportunities and risk exposure in support of clinical program management strategy and business planning
• Support the development and evaluation of test-and-learn initiatives including tracking and ad hoc assessments needed for day-to-day business operations
• Partner with finance network and clinical teams to implement performance improvement actions based on observed outcomes and evaluation findings
• Oversee clinical pilots and improvement initiatives from implementation through evaluation including defined success metrics and performance monitoring
• Maintain awareness of policy and regulatory influences on cost and quality measurement to ensure compliance

Population Health Strategy and Measurement

• Identify and manage key medical cost and utilization drivers through active oversight of population health initiatives and associated outcome measures
• Establish and maintain population health measurement frameworks that use actuarial forecasts trend analyses and clinical data to monitor outcomes utilization and emerging risks
• Ensure effective clinical programs are incorporated into routine performance monitoring forecasting and financial evaluation processes
• Partner with market clinical executives to evaluate local initiative impact refine intervention design scale effective approaches and discontinue lowvalue activities
• Oversee external population health partnerships to ensure tools and outputs directly support clinical evaluation and performance management in support of external provider partners

Evaluation and Dissemination

• Ensure the rigorous evaluation of clinical and population health initiatives assessing clinical effectiveness affordability impact operational performance and strategic importance
• Communicate and disseminate findings and lessons learned to support accountability and improvement
• Support internal and external dissemination of clinical performance and population health findings including sharing results with provider partners and disseminating more broadly in lay and peer-reviewed venues to promote transparency learning and improvement
• Contribute to enterprise reporting and presentations that highlight outcomes performance trends and successful clinical initiatives

Leadership & Team Oversight

• Lead multidisciplinary teams responsible for clinical performance measurement program execution and continuous improvement
• Ensure clinical rigor analytic discipline and accountability for results
• Coordinate execution across clinical finance network and analytics partners

Required Qualifications

• Education: Bachelors degree in health services research statistics economics finance data science public health or a related field required; Masters degree (MPH MBA MHA or equivalent) strongly preferred

• Demonstrated experience leading clinical performance improvement or population health programs with direct responsibility for business planning outcomes and evaluation

• Strong analytical and actuarial fluency applied to clinical and operational performance
• 8 years of progressive healthcare leadership experience including involvement in valuebased care network performance affordability or population health execution
• Experience developing and applying quality outcome utilization and affordability measures to manage clinically oriented programs
• Ability to clearly communicate performance results and evaluation findings to clinical operational and executive audiences

Preferred Qualifications

• Formal actuarial training or significant experience working with actuarial models in support of clinical program evaluation
• Advanced training in statistics economics data science or health services research
• Experience supporting pricing forecasting or financial performance evaluation for clinical programs
• Experience in commercial healthcare affordability and valuebased care environments

Core Competencies

• Clinical judgment and credibility
• Ownership of outcome measurement and evaluation
• Analytical and actuarial fluency applied to clinical performance
• Performance monitoring and continuous improvement
• Provider partnership and transparency
• Accountability for measurable results

About The Cigna Group

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 tobacco-free 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.