Chief Clinical and Quality Officer

The Cigna Group•Bloomfield, CT

46d•Onsite

About The Position

The Chief Clinical Quality Officer (CCQO) at The Cigna Group is responsible for overseeing the quality and safety of healthcare services ensuring the delivery of safe, effective, and patient-centered care while aligning quality initiatives with the company’s strategic goals and operational excellence. This role will lead a cross-functional team of clinical and business leaders to build solutions, processes and functions that ensure a high degree of clinical integrity, quality and safety. The CCQO will work closely with the CMOs, policy teams, safety infrastructure, compliance and legal teams, and technology teams to drive quality improvement initiatives, leverage data analytics and reporting, and enhance patient outcomes and satisfaction.

Requirements

MD or DO with board certification.
15+ years of leadership experience in a large healthcare organization, including 5+ years in direct leadership of patient experience and quality improvement.
Strong knowledge of healthcare quality standards and patient experience strategies.
Excellent leadership skills, strategic thinking, and ability to execute for results in a complex commercial environment.
Proven ability to innovate and drive organizational change.
Experience in a highly matrixed organization with strong internal enterprise relations.
Strong communication skills, with the ability to translate complex topics into consumable formats.

Responsibilities

Develop and implement quality improvement and outcome strategies aligned with organizational goals.
Collaborate with stakeholders to set and monitor key performance indicators (KPIs) related to healthcare quality and outcomes.
Oversee quality assurance programs to ensure compliance with local, state, and federal regulation and with healthcare quality standards, including HIPAA, JCAHO, and CMS as well as HEDIS, NCQA Health Plan Ratings, STARS, and CAHPS compliance.
Identify and mitigate risks related to healthcare quality and implement continuous improvement methodologies like Six Sigma or Lean Healthcare.
Lead the development and implementation of a robust clinical safety framework across all care and health services delivery settings.
Oversee incident reporting systems, root cause analyses (RCA), and failure mode and effects analyses (FMEA) to proactively identify and mitigate risks.
Establish and monitor clinical safety KPIs, including adverse event rates, sentinel events, and near misses.
Collaborate closely with legal, compliance and FWA teams.
Ensure timely investigation and resolution of safety events, with transparent reporting to leadership and regulatory bodies.
Collaborate with clinical leaders to embed evidence-based safety protocols and promote a culture of high reliability.
Champion infection prevention and control programs, medication safety initiatives, and patient harm reduction strategies.
Collaborate with stakeholders to develop business cases and monitor performance.
Lead and develop a multidisciplinary team focused on clinical excellence, quality and safety.
Foster a culture of continuous improvement and innovation.
Represent the department in executive meetings and external forums.
Collaborate with internal entities, healthcare providers, and members/patients to improve quality and integration of interventions.
Engage with industry experts and participate in relevant forums and committees.