The Senior Director of Medical Economics, Evernorth Medical Network Solutions will lead the economic design of a new, multipurpose, flexible, and customizable medical network that can serve the needs of multiple businesses across Evernorth and the Cigna Group. This role will partner closely with Provider Contracting on both fee-for-service and value-based contracting efforts to meet the evolving needs of health care providers and payers in new and innovative ways. In addition, this role will partner closely with health care providers to provide timely and actionable insights supporting better access, affordability and health outcomes for the patients they serve.
Duties And Responsibilities
The Senior Director of Medical Economics oversees an organization of 8+ actuarial and business analytics team members and is responsible for the following:
Provider Contracting Support
- Supports Evernorth’s overall medical contracting strategy through analytical insights and close partnership with the Provider Contracting team
- Secures the appropriate tools and training to evaluate both fee-for-service and value-based contracts
- Oversees the economic assessment of individual provider contracts
- Oversees the evolution of Evernorth’s high-performing provider methodology which incorporates both cost and quality metrics
- Leads the economic design of new value-based care contracting solutions for both payers and providers
- Leads the management of payer rates to meet contractual guarantees for payer clients
Population Health & Provider Engagement Support
- Drives population health strategy and execution in close partnership with Data & Analytics, Office of the Chief Health Officer (OCHO), Technology and external vendor partners.
- Oversees the identification of total cost of care (TCC) opportunities and development of TCC action plans to achieve financial goals in collaboration with internal and external business partners
- Measures execution against strategic actions to drive accountability
- Identifies emerging trends and influences relevant business decisions
- Fosters a collaborative approach with internal Provider Engagement and Provider Contracting teams as well with external provider partners
Business Strategy Support
- Provides analytics and insights to support growth strategy and guide strategic decision-making as a valued member of the broader Evernorth team
Leadership And Talent Development
- Lead a team of 8+ actuarial and business analytics staff members in achieving the goals outlined above
- Sustainably grow the team to meet the future goals of the business. Attract, develop and inspire high-performing talent.
- Create a supportive team environment that includes training and development, regular feedback, support for exam progress (as applicable), and ongoing career counseling
- Foster a culture of growth and innovation.
The job profile for this position is Actuarial Senior Director, reporting to the Managing Director of Product and Analytics within Evernorth Payer and Provider Solutions.
Qualifications
- Bachelor’s degree in Actuarial Science, Finance, Mathematics, Data Science or related field
- FSA, MBA or equivalent advanced degree strongly preferred
- 10+ years of experience with financial analysis, data analysis, data management, actuarial and/or healthcare analytics
- At least 2+ years of managerial experience; demonstrated ability to attract and recruit top talent, inspire a team, delegate effectively, celebrate diversity and manage performance
- Adept at influencing internal and external counterparts, as well as Senior Leadership
- Demonstrated ability to lead in a highly dynamic, ambiguous and complex business environment
- Proven ability to collaborate effectively across multiple functions and form strong relationships with both internal and external business partners
- Proven ability to combine strong business acumen with analytic skills to drive growth, innovation and overall business strategy.
- Accountability in driving results.
- Comfortable taking calculated risks. Able to foresee and articulate potential outcomes.
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.
For this position, we anticipate offering an annual salary of 171,400 - 285,600 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus and long term incentive plan.
We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna.
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. 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.
Cigna 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.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
