Job Responsibilities : RN Clinical Program Sr. Advisor. Work from Home, New England or Boston Metro Area
Salary : $105,500 – $175,800 a year
Company : Cigna
Location : Remote US
Cigna’s mission is to improve the health well-being and sense of security for those we serve. The Market Facing Clinical 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.
The Clinical Program Sr Advisor as part of the Market Facing Clinical 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
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
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 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.
For this position we anticipate offering an annual salary of $105500 – $175800 depending on relevant factors including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
Helping our customers achieve healthier more secure lives is at the heart of what we do. While you take care of our customers we’ll take care of you through a comprehensive benefits program that helps you be at your best. Starting on day one of your employment you’ll be offered several health-related benefits including medical vision dental and best in class 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 dozens of corporate discounts on essentials you use every day. For more details on our employee benefits programs please visit the “Life at Cigna” tab on our careersite: www.cigna.com/careers
Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health well-being and peace of mind of those we serve. Together with colleagues around the world we aspire to transform health services making them more affordable and accessible to millions. Through our unmatched expertise bold action fresh ideas and an unwavering commitment to patient-centered care we are a force of health services innovation. When you work with us or one of our subsidiaries you’ll enjoy meaningful career experiences that enrich people’s lives. What difference will you make?
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.