Director, Clinical Program & Operations Management for VBC, Network, and Provider Experience

Company Description

Cigna Healthcare is a health benefits provider committed to advocating for better health at every stage of life. We empower our customers with valuable information and insights, helping them navigate the healthcare system with confidence. Our goal is to inspire healthier, more vibrant lives through personalized care.

Role Description

This role leads clinical execution for enterprise Value-Based Care (VBC), Network, and Provider Experience by translating clinical strategy into operating models, messaging, and scalable delivery that improves affordability, provider experience, and clinical outcomes. The Director reports to the enterprise Associate Chief Medical Officer for Provider Experience, Network, and VBC and partners with strategic business units, provider organizations, and enablement partners. This position owns governance and performance management, supports operating model execution, and escalates risks and dependencies through concise, executive-ready communication.

Key Responsibilities

VBC, Provider Experience, and Clinical Network Operating Models

• Run the operating cadence (intake through sequencing) and coordinate joint planning with key partners.
• Maintain standards (taxonomy, playbooks, RACI, stage gates, change control) with matrix partners.
• Balance demand and capacity across program operations, clinical teams, and matrix partners; allocate resources accordingly.
• Standardize governance, roles, reporting, and escalation across VBC initiatives to drive consistent delivery and accountability.

End-to-End VBC and Clinical Program Delivery

• Lead and coach Operation/Program Managers; reinforce disciplined execution and timely escalation.
• Own implementation plans for priority initiatives from pilot through scale.
• Drive delivery across markets; manage risks, dependencies, and value realization, and communicate impact and trade-offs clearly.

Performance Management, Data & Insights

• Set expectations tied to outcomes, value capture, and stakeholder experience.
• Define each initiative’s value proposition (problem, outcomes, leading/lagging metrics, expected value capture); track KPIs/OKRs and communicate progress with aligned messaging.
• Lead monthly performance reviews using dashboards/scorecards; drive decisions and actions.

Process Excellence & Change Management

• Standardize governance forums, core artifacts, and playbooks.
• Improve core processes (provider engagement, rollouts, issue and escalation management).
• Lead change communications, stakeholder messaging, and training to drive adoption across markets and teams.

Governance, Compliance, Budget & Vendors

• Run governance forums with audit-ready documentation and policy adherence.
• Manage budgets/forecasts, value cases, benefits realization, and vendor/consultant SLAs; communicate performance and value to executives and field teams.

Cross-Functional Collaboration

• Establish decision rights and escalation paths across matrix partners.
• Align priorities, decisions, and stakeholder messaging; unblock delivery through a shared operating cadence.
• Translate analytics into operational workflows and provider-facing materials.
• Partner with provider organizations on operating model design, performance goals, implementation readiness, and feedback loops.
• Partner with strategic business units to develop and scale solutions that measurably improve provider experience.

Team Leadership

• Build and lead a high-performing team through clear goals, coaching, and transparent collaboration.
• Develop talent through clear roles, growth plans, and progression.

Required Qualifications

• Executive communication and strategic storytelling; ability to influence senior clinical and business leaders.
• 10 years leading programs, portfolios, or operations in payer, provider, or integrated delivery settings.
• Value-based care expertise, including provider contracting and network strategy.
• Advanced degree and/or clinical background; consulting experience a plus.
• Experience building program management operating models and delivering complex initiatives from pilot through scale in matrixed environments.
• Strong analytical and critical-thinking skills; translate data into decisions, strategy, and KPI governance.
• Develop executive-ready presentations and deliver board-level updates on performance, risks, and decisions.
• Highly motivated and intellectually curious; proactive, accountable, and continuously improving.

Core Competencies

• Clinical credibility and strategic, systems-level thinking with operational rigor
• Data-driven problem solving; synthesizes insights into clear recommendations.

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.