Cigna

Network and Provider Strategy Lead

Posted on: 25 Apr 2021

San Francisco, CA

Job Description

** This role may be based anywhere in the US

This role will be the dedicated leader for delivery systems within the International Markets strategy Health Consulting Team, which will be responsible for delivering internal and external transformational projects across International Markets.

This role will be the leader for delivery systems, ranging from physician organizations to complex integrated delivery systems with hospital ownership.  As a seasoned and highly experienced partner or organizer of delivery systems, this role will be responsible for designing, presenting, and influencing delivery system strategy within internal market and IM leadership as well as external partners’ executive leadership.


The role will be a thought leader delivery systems for International Markets with a broad and deep knowledge base on Cigna’s global capabilities and models as well as market best practices.

Some responsibilities that will be required of the role include;

Influencing strategic direction, product/benefit design teams, IT architecture teams, and network development teams at executive levels.

Driving alignment and recommending tradeoffs for market strategies and timelines to deliver a meaningful ROI for Cigna and its clients

Designing product offerings, joint processes, and governance models that support both the external partner’s needs and Cigna’s needs.

Regularly interacting with external and internal strategy/business development teams, Cigna DSA engagement teams, and other key operations partners to ensure knowledge and capability is aligned to International Markets strategic direction

Expertise in delivering medical cost through organization of physicians or creation of sustainable partnership models between payors and delivery systems

RESPONSIBILITIES:

Responsible for development and execution of delivery system strategy across transformation projects by influencing internal International Markets leadership and external executive leadership. The individual will need to lead delivery system strategy for the health consulting team, including the following:

            a. Development of delivery system strategy in concert with IM leadership and external partner’s leadership to drive long-term delivery system value creation,

             b. Development of product roadmaps for all health related products, and

             c. Integration with enablement teams for execution.

Be a thought leader for International Markets across delivery system strategy, partnership models, medical cost delivery, and best practices.

Be able to travel at short notice to be onsite for potentially significant periods of time (3 months) to deliver transformational projects in market

QUALIFICATIONS:

Bachelor’s degree required, MBA or MHA strongly preferred.

5 plus years contracting experience involving complex delivery systems and organizations, with specific experience in designing products or partnership models a plus. Negotiation experience a plus as well.

Skilled and expert in contracting skills, to include proficiency in contracting at national level, with external entities and demonstrated success in preparing contracts which involve complex reimbursement methodologies

Experience in interacting with external Delivery System (hospital or physician) c-suite personnel in business partnership or material and complex price negotiations.

Strong written and verbal communication skills

The successful candidate will be particularly proficient in the following competencies;

Managing Vision and Purpose

Dealing with Ambiguity

Organizational Agility

Organizing

Informing

This position is not eligible to be performed in Colorado.

Cigna

Bloomfield, CT

Cigna Corporation, a health service organization, provides insurance and related products and services in the United States and internationally. It operates through Integrated Medical, Health Services, International Markets, and Group Disability and Other segments. The Integrated Medical segment offers medical, pharmacy, dental, behavioral health and vision, health advocacy programs, and other products and services to insured and self-insured clients; Medicare Advantage, Medicare Supplement, and Medicare Part D plans to Medicare-eligible beneficiaries, as well as Medicaid plans; and health insurance coverage to individual customers on and off the public exchanges.

The Health Services segment provides clinical solutions, specialized pharmacy care, home delivery pharmacy, retail network pharmacy administration, benefit design consultation, drug utilization review, drug formulary management drug claim adjudication, digital consumer health and drug information, provider, and medical benefit management services. The International Markets segment offers supplemental health, life and accident insurance products, and health care coverage, as well as health care benefits to mobile employees of multinational organizations.

This segment offers health coverage, hospitalization, dental, critical illness, personal accident, term life, and variable universal life products. The Group Disability and Other segment provides group long-term and short-term disability, group life, accident, and voluntary and specialty insurance products and related services; and permanent insurance contracts to corporations to provide coverage on the lives of certain employees for the purpose of financing employer-paid future benefit obligations. The company distributes its products and services through insurance brokers and insurance consultants; and directly to employers, unions and other groups, or individuals. Cigna Corporation was founded in 1792 and is headquartered in Bloomfield, Connecticut.

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