Director, Value-Based Care Performance and Provider & Network Experience - Cigna Healthcare - Hybrid

The Cigna Group•Tampa, FL

1d•Hybrid

About The Position

The Director of Value‑Based 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 decision‑making, 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 Value‑Based 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.

Requirements

Education: Bachelor’s degree in health services research, statistics, economics, finance, data science, public health, or a related field required; Master’s 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 value‑based 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
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Nice To Haves

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 value‑based care environments

Responsibilities

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 provider‑facing 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
Maintain operational responsibility for defining and measuring clinical performance outcomes and affordability impact across value‑based 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
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 low‑value activities
Oversee external population health partnerships to ensure tools and outputs directly support clinical evaluation and performance management in support of external provider partners
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
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