About The Position

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 Clinical's Value-Based Care (VBC), Trend and Network Management team in support of driving Total Cost of Care (TCOC) performance, improving clinical outcomes, and advancing Cigna's 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 data-driven solutions and strategic collaborations. The successful candidate for this role will be a physician leader with extensive value-based 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 risk-based 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 organization's 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 growth-oriented, motivational, and collaborative mindset capable of building strong relationships and partnerships at all levels of the organization.

Requirements

  • MD/DO degree required; MBA and/or relevant business experience (10-15 years) preferred.
  • Minimum of 10 years of experience in healthcare leadership, value-based care strategy, and provider network management.
  • Minimum of 5 years of experience in clinical practice.
  • Strong understanding of healthcare financial modeling, trend analysis, and clinical performance improvement.
  • Exceptional leadership and relationship-building 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.
  • Experience demonstrating iterative and synergistic solutions with near-term value delivery in service of longer-term 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.

Responsibilities

  • Advance Cigna's existing alternative payment model strategy; this may involve creating new structures or partnering with innovative value-based 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.
  • Partner with financial teams to identify and understand TCOC drivers and to translate insights into clinical actions to improve and coordinate care.
  • Establish and lead a regionally-oriented team of dedicated Medical Executives and Nurse Executives to manage provider performance and network management.
  • Partner with the provider services team to bolster providers' experiences of working with Cigna through structured interventions and hands-on relationship management.
  • Develop a cross-clinical 'brain trust' team to provide structured insights to actuarial and underwriting partners informed by anticipated clinical trends and innovations.
  • Build and manage high-performing teams, comprised of medical executives, nurse executives, operators and subject matter experts specializing in value-based care, clinical trend, and network strategy.
  • Implement scalable processes to enhance VBC adoption, track performance outcomes, and adjust strategy based on real-time data insights.
  • Define and track key performance indicators (KPIs) to assess the impact of VBC strategies, ensuring continuous improvement and market competitiveness.
  • Staff with top-level talent, bringing best-in-class internal clinical, strategy, and operations talent together alongside external talent with new and innovative perspectives.
  • Be respected organization-wide as being staffed with clinicians who bring both clinical expertise, patient-focused integrity and compassion, and a sharp business and P&L mindset.
  • Be oriented to managing work from vision through to completion, with a quantitative orientation and an ability to get stuff done.
  • Navigate complex cross-matrix working relationships and dynamics with ease and an ability to successfully drive work through collaboration and influence.

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