General Purpose:
Cigna's mission is to improve the health, well-being and sense of security for those we serve. The Clinical Sales and Network Organization, as Champions for affordable, predictable and simple health care, is dedicated to achievement of our Enterprise goals improving affordability and customer health outcomes, client growth and retention, and network performance.
Role Summary
The Clinical Program Sr Advisor, as part of the Clinical Sales and Network Organization, is closely aligned with Network Provider Partners, Clients and Key Stakeholders to support improved healthcare quality and affordability while ensuring customer satisfaction. This role is responsible to execute on strategic priorities to meet organizational goals related to Client Growth and Retention, Total Medical Cost and Value-Based Provider Performance.
Scope of work includes, but not limited to:
- Applies fundamental knowledge of business segment strategies, distribution channels and healthcare industry trends to deliver clinical insights and consultancy in support of Network, Sales, and local market Affordability strategies.
- In partnership with the Market Medical Executive and Collaborative Care (CCC) Program Team, consults regularly with provider partner/s on activities that drive improved performance and CCC program success in quality, affordability and experience of care.
- As a clinical point of contact for Cigna's Value-Based Provider Partner/s, is responsible for the relationship with the ECC (Embedded Care Coordinator/s), interacting onsite or virtually to ensure an effective Key Focus Action Plan (KFAP) is developed and enacted to drive optimal performance and achievement of value-based goals.
- Conducts value-based provider partner infrastructure integrity and clinical capability assessments.
- Engages with network partners to influence practice redesign and adoption of advanced practice tenets that support Population Health Management and clinical integration integral to long term success.
- Facilitates Network Provider supported Client/Producer meetings and events to educate, support Cigna's integrated value, and grow our CAC’s and Provider Anchor Partners.
- Enables the connection between Cigna’s Clinical Operations teams and our Network Provider Partners, identifying pathways to improve collaboration and integrated/coordinated care that optimize outcomes for our Network, Clients and Customers.
- Local market TMC (Total Medical Cost) committee member, conducts opportunity analysis and executes on initiatives to drive trend and cost of goods sold (COGs) reduction that improve customer/client Affordability.
- As Clinical SME and healthcare industry expert, participates in cross-functional teams at the local or national level, identifying and implementing actions that improve organizational or enterprise effectiveness and Affordability.
- Clinical Advisor to the Client Account Team (Sales, Underwriting, Client Reporting, Wellness, Operations / others), provides data analysis, clinical insights, consultative guidance and recommendations for clients that positively impact customer engagement, client affordability, persistency and growth.
- Ensures client understanding of Cigna's integrated value and satisfaction with Cigna programs, products and services.
- Collaborates with matrix partners (i.e. Sales, Clinical Operations, Client Health Engagement, others) to execute on strategies and solutions to meet Growth and Persistency, Program Engagement and Affordability targets.
- Facilitates resolution to complex clinical issues and non-standard client benefit requests.
- Partnering with Sales and Clinical Operations, supports cultural trainings, readiness assessments, vendor integrations and audits to ensure a seamless onboarding and continued positive client experience.
The ideal candidate must reside in Northeast New York, New Jersey or Connecticut
Qualifications:
- Active and unrestricted Nursing License.
- Required Bachelor’s degree, Advanced Degree preferred.
- Minimum of three (3) years of clinical practice experience.
- Proven industry experience in a Health Sector related field (Health Insurance; Healthcare Professional and/or Delivery System Entities or Allied Health Industry).
- Strong Leadership, Organizational, Critical Thinking and Execution skills.
- Can work effectively in a matrixed environment.
- Proven ability to build strong relationships, foster collaboration and influence diverse teams.
- Excellent oral and written communication skills, including formal presentations for all levels of management.
- Proficient in using Microsoft Office Technology/Software applications.
- Requires intermittent travel within assigned market.
Organizational Competencies:
- Customer Focus: Relating openly and comfortable with diverse groups of people. Is dedicated to meeting the expectations and requirements of internal and external customers; gets first-hand customer information and uses it for improvements in products and services; acts with customers in mind; establishes and maintains effective relationships with customers and gains their trust and respect.
- Interpersonal Savvy: Building strong customer relationships and delivering customer centric solutions. Builds rapport by identifying common interests and priorities. Exercises diplomacy in difficult interpersonal situations. Relates well to a broad variety of people inside and outside the organization. Responds appropriately to social cues.
- Communicates Effectively: Developing and delivering multimode communications that conveys a clear understanding of the unique needs of different audiences. Conveys information clearly, concisely, and professionally. Listens attentively to others and takes an interest in what they have to say. Consistently endeavors to keep others well informed. Documents efforts appropriately and provides clear written information.
- Manages Complexity: Making sense of complex high quantity and sometimes contradictory information to effectively solve problems. Looks at complex issues from multiple angles; gains a sound understanding of the topic. Recognizes the main consequences and implications of different options. Explores issues and uncovers the underlying issues and root causes. Determines the new information needed to solve problems and incorporates these concepts into the analysis.
- Drives Results: Consistently achieving results even under tough circumstances. Demonstrates a strong drive to achieve meaningful results. Drives tasks to successful completion and closure. Shows determination in the face of obstacles and setbacks. Sets high standards for own performance.
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.
About Cigna Healthcare:
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
