Medical Director - Clinical Strategy

The Cigna Group

12d•$212,600 - $354,300

About The Position

The Medical Director, Clinical Strategy will support the development and execution of Cigna Healthcare’s strategy for members with high-risk and complex care needs, including people with complex chronic conditions, oncology needs, high drug spend, serious illness, and specialty pharmacy needs. Reporting to the Associate Chief Medical Officer for Clinical Product and Solution Design, the role translates clinical, business, and affordability priorities into strategic roadmaps, scalable clinical programs, digital and AI-enabled solutions, business cases, and measurable execution plans. The role partners across Clinical, Product, Strategy, Technology, Data, Operations, Pharmacy, Finance, Analytics, and market-facing teams to identify priority opportunities, design differentiated solutions, support implementation, and measure impact. A core focus is developing digital and AI-enabled solutions for high-risk members, including AI agents, advanced segmentation, proactive engagement, digital navigation, clinical workflow support, and technology-enabled case management. This strategic and execution-oriented position combines clinical insight, business acumen, analytics, digital fluency, and cross-functional leadership to improve outcomes, affordability, member experience, and enterprise value. Solutions should be clinically sound, member-centered, operationally feasible, financially grounded, measurable, and aligned with responsible innovation principles.

Requirements

Active and unrestricted medical license in a state.
Current board certification in an ABMS- or AOA-recognized specialty.
At least 3 years of clinical practice experience.
Experience developing and implementing strategy for healthcare-related organizations, including payer, provider, pharmacy, clinical services, health services, consulting, digital health, or related sectors.
Experience developing clinical programs and driving execution from concept through implementation, adoption, and measurable outcomes.
Strong business and/or consulting experience, including structuring complex problems, synthesizing insights, developing recommendations, and translating strategy into action.
Solid business and financial acumen, including the ability to connect clinical initiatives to affordability, value creation, operational performance, client needs, and enterprise impact.
Experience using analytics, data, and performance insights to identify opportunities, shape strategy, guide decisions, and measure outcomes.
Experience leading teams or cross-functional workgroups to execute complex projects in a matrixed environment.
Process improvement experience, including improving workflows, operating models, execution processes, and scalable program delivery.
Ability to influence stakeholders, establish alignment, and drive improved clinical, operational, financial, and business outcomes.
Strong executive communication skills, including translating complex clinical, operational, financial, analytical, and technical topics into clear, concise, leadership-ready materials.
Digital and AI fluency, including ability to partner with Product, Technology, Data, and Clinical teams to develop digital and AI-enabled solutions for high-cost claimants, such as AI agents, advanced segmentation, proactive engagement tools, and technology-enabled case management workflows.

Nice To Haves

Experience in payer strategy, care management, complex care, oncology, specialty pharmacy, high-cost therapies, serious illness care, chronic condition management, value-based care, or clinical product design.
Experience with digital health, AI-enabled clinical solutions, AI agents, predictive analytics, intelligent workflow design, member engagement tools, or technology-enabled care navigation.
Experience working in a national health plan, health services organization, clinical operations environment, healthcare consulting firm, provider organization, pharmacy organization, or digital health company.
Experience developing executive-level business cases, investment recommendations, operating models, or transformation roadmaps for clinical programs.

Responsibilities

Support development and execution of Cigna Healthcare’s strategy for members with high-risk and complex care needs, including oncology, high drug spend, serious illness, specialty pharmacy needs, and complex chronic conditions.
Translate clinical and business priorities into strategic roadmaps, business cases, implementation plans, and measurable performance goals.
Lead the design of scalable clinical programs for high-risk and complex populations, including identification, engagement, navigation, escalation, care coordination, and longitudinal support.
Lead development of digital and AI-enabled solutions for high-risk members, including AI agents, advanced segmentation, proactive outreach, member-facing navigation, clinician workflow support, and next-generation case management capabilities.
Partner with Product, Technology, Data, Clinical Operations, Pharmacy, Analytics, Finance, and market-facing teams to identify priority use cases, define requirements, and support execution through implementation.
Use data, analytics, claims insights, clinical and pharmacy trends, operational performance, and client needs to identify opportunities and prioritize initiatives.
Improve case management and complex care models, including structured case review processes, high-risk case management, and targeted interventions for priority populations.
Develop performance measurement frameworks and KPIs related to clinical outcomes, affordability, member experience, engagement, operational efficiency, clinician adoption, and client value.
Drive process improvement and operating model enhancements to improve scalability, consistency, and execution discipline.
Align stakeholders across a matrixed organization to establish shared priorities and improve business outcomes.
Prepare executive-ready strategy documents, updates, recommendations, and decision materials for senior leadership.
Lead cross-functional teams and workgroups through complex initiatives, fostering accountability and collaboration.
Bring an outside-in perspective on clinical innovation, digital health, AI-enabled care models, oncology, specialty pharmacy, high-cost therapies, GLP-1s, gene therapy, and other emerging areas relevant to clinical product strategy.
Help ensure digital, AI-enabled, and clinical solutions are clinically sound, member-centered, operationally feasible, financially grounded, measurable, and aligned with responsible innovation principles.