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Position Summary

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.

Key Responsibilities

Provider Experience and Measurement

• 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

Value-Based Care and Network Performance

• 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

Population Health Strategy and Measurement

• 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

Evaluation and Dissemination

• 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

Leadership & Team Oversight

• 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

Required Qualifications

• 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

Preferred Qualifications

• 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

Core Competencies

• Clinical judgment and credibility
• Ownership of outcome measurement and evaluation
• Analytical and actuarial fluency applied to clinical performance
• Performance monitoring and continuous improvement
• Provider partnership and transparency
• Accountability for measurable results

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 The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.