Chief Medical Officer- Cigna Healthcare

Chief Medical Officer

The Chief Medical Officer will be responsible for the following key areas of focus :

Implements Clinical Strategy, Solution and Program Design : Implements and advances the overall clinical strategy in support of the transformation of the health plan offerings to deliver value through exceptional patient and provider experience, high quality outcomes, more affordable care, and with the use of modernized digital, technology, and data capabilities.

Oversees Medical Management : Provides strategic leadership and oversight for all medical management functions, including case management (CM), utilization management (UM), and escalated case review. Ensures policies, procedures, and governance frameworks are in place to deliver a high-functioning, compliant health plan that meets regulatory requirements and internal standards. Drives excellence in clinical quality and consistency across programs while maintaining a seamless, positive experience for members and providers. Partners with internal teams to monitor performance, resolve complex cases, and continuously improve processes that safeguard patient outcomes and operational integrity.

Serves as the External Clinical Face of Health Plan to the Market : Acts as the primary clinical ambassador for Cigna Healthcare, engaging with clients of all sizes across employer groups, as well as consultants and brokers. Plays a critical role in the sales process, account management, and ongoing performance oversight by providing clinical insight and executive sponsorship. Builds and nurtures strategic relationships with key stakeholders to strengthen trust and partnership. Represents Cigna in the provider community to foster collaboration, influence clinical policy, and advance value-based care initiatives. Ensures that every external interaction reflects Cigna's commitment to quality, affordability, and an exceptional member experience.

Drives Clinical Product Strategy and Design : Leads the development and execution of Cigna Healthcare's clinical product strategy to ensure a market-leading clinical value proposition and compelling external narrative. Shapes and oversees the design of differentiated programs, including best-in-class case management and innovative solutions in high-impact areas such as GLP-1 therapies, gene therapy, women's health, and other core and emerging clinical domains. Partners with product, technology, operations, and business teams to create solutions that deliver measurable outcomes, supported by robust proof points and performance metrics. Ensures that Cigna's clinical programs stand out in the marketplace through demonstrated results, scalability, and alignment with client needs, while reinforcing our commitment to quality, affordability, and innovation.

Implements and Advances Value-Based Care Strategy : Leads the next chapter of Cigna Healthcare's value-based care (VBC) journey, including oversight of our ACO model and development of innovative approaches to strengthen plan-provider alignment. Drives adoption of VBC enablers such as data integration, performance measurement, and incentive structures that improve quality and affordability. Pilots novel care models and partnerships to accelerate transformation while ensuring alignment with the broader enterprise network strategy. Positions Cigna as a market leader in value-based care through measurable outcomes, proof points, and a compelling external narrative.

Collaboration Across Clinical Leadership : Ability to work seamlessly with other clinical leaders across the enterprise, serving as a key member of the clinical leadership bench. Thought partner to the enterprise CMO and peers to ensure integration of clinical strategy with each business's objectives, fostering alignment and shared accountability.

Advances Clinical Data and AI Strategy : Champions a data-first mindset to transform CHC's clinical strategy through advanced analytics and AI. Leads efforts to harness data and AI for superior member experience, personalized care, improved outcomes, and operational efficiency. Partners closely with data, technology, and business teams to identify and execute clinical use cases that drive measurable impact. Ensures all AI applications adhere to rigorous clinical standards and governance guardrails to maintain trust and safety. Positions Cigna Healthcare at the forefront of digital innovation by embedding AI into clinical workflows while maintaining transparency, compliance, and a commitment to quality.

Drives Health Equity Strategy : Leads the design and implementation of the next phase of Cigna Healthcare's health equity strategy, ensuring measurable business impact and alignment with our mission. Embeds a health equity lens across clinical programs to drive better outcomes for all patients, reduce disparities, and improve access to high-quality care. Establishes clear proof points and performance metrics to demonstrate progress and accountability, while partnering across the enterprise to integrate equity principles into product design, policy, and care delivery.

Builds and Inspires our New Age Clinical Workforce : Sets the sourcing, recruitment, and onboarding strategy for building the team of clinicians who can support and drive the business strategy. Ensures our clinical teams are supported, engaged, and inspired to deliver exceptional outcomes. Leads and executes strategies to make Cigna an employer of choice for clinical talent through a differentiated employee value proposition that ensures the sustainability and well-being of our teams. The CMO will be the major clinical voice for Cigna Healthcare's US market president and senior leadership team.

Partners with Enterprise Clinical Leadership : Collaborates and engages Clinical leaders / peers across the enterprise to support the enterprise clinical strategy and build out clinical community.

The successful candidate will be a forward-thinking, flexible physician executive with a broad understanding of the healthcare industry, its challenges and opportunities, and deep experience within health plans. This leader will know how to navigate the complexities of a health plan environment to deliver results that align clinical priorities with business strategy. They will demonstrate genuine intellectual curiosity and a collaborative mindset, working effectively across a complex, matrixed organization with a servant leadership disposition. The individual will be an innovative thinker and problem-solver with a proven ability to lead transformative change while fostering trust, engagement, and retention of top clinical talent. The ideal candidate will combine clinical expertise, digital and technology depth, and strong business acumen with a results-oriented focusdriving measurable impact on both clinical outcomes and enterprise growth objectives.

Experience & Expertise :

Clinical Execution : Ability to deliver a clinical vision for the business. The skills to shape and implement the development of forward-looking strategies that align with overarching enterprise objectives. Can identify opportunities for improvement that balance profitable business and clinical outcomes (e.g., patient outcomes, cost containment, and quality of healthcare services).

Enterprise Value Creation and Scaling Commercial Solutions : Ability to align clinical metrics / outcomes with a direct linkage to enterprise value creation and member health to create a clear mandate and accountability that prioritizes high-value areas. Experience overseeing the end-to-end development and scaling of healthcare solutions. Can drive innovation through the implementation of technologies and care models. Strong understanding of finance, technology, and the levers to pull in business development and sales.

Thought Leadership and Clinical Face-To-Market : Track record of engaging with diverse external stakeholders in the community to stay informed and shape the latest clinical and policy developments. Experience serving as the clinical face outside the organization to help inform and validate decision-making processes and provide insight supporting the business development lifecycle. Fosters collaborations to enhance care delivery and contribute to discussions in the public policy arena. Plays a crucial role in market-facing change and crisis management communications related to the Cigna health plan, ensuring effective and clear messaging to all stakeholders.

Clinical Leadership : Gravitas to serve as the highest point of clinical leadership in Cigna Healthcare. Skills and experience to effectively have end-to-end oversight of the clinical model (including P&L) for all programs and care delivery businesses while creating a high-quality patient care culture. Can balance clinical choices with business outcomes to gain market traction and deliver financial results.

Health Plan and Medical Management Expertise : Deep experience operating within health plan environments, including fluency in medical management functions such as utilization management (UM), case management (CM), policy development, and governance. Proven ability to navigate complex plan structures and deliver compliant, high-performing operations that enhance member experience and clinical quality.

Transformation & Change : Leads masterfully and empathetically through change in a complex matrixed environment (e.g., transformation of ways of working / processes, vision / priorities / culture and technology application). Manages transformation through practices such as creating a vision and purpose, frequent and timely communication, leadership alignment, stakeholder engagement, educating / training the organization, and overcoming resistance. Builds strong working relationships rooted in collaboration and trust.

Value-Based Care : Deep experience transitioning healthcare delivery models toward value-based care, emphasizing outcomes and cost-effectiveness.

Building Next Generation Clinical Talent : Has direct people management responsibility for a team through the full talent lifecycle : attracting, hiring, onboarding, developing, managing performance, and promoting talent, as well as existing team members when necessary.

Compliance, Safety and Quality Care : Cultivates a culture and fosters practice across the care delivery teams that prioritizes high quality, safe, and compliant operations within the Healthcare Sector.

REQUIRED SKILLS :

MD / DO degree required