Role Description
This role provides leadership across Premium Solutions clinical operations, product integration, and business performance. The position is responsible for operational execution, clinical outcomes, alignment to product strategy, and financial performance for high-value client segments.
Working closely with the Managing Director of Case Management Operations and senior cross-functional partners, this role connects strategy with execution to support the design, implementation, and ongoing improvement of differentiated service models that drive client retention, growth, and operational scalability.
This position may require presence in an office if your location is within reasonable proximity to a Cigna office.
Responsibilities
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Lead clinical operations and case management programs across Premium Solutions client segments.
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Drive performance across quality, engagement, operational efficiency, and client experience metrics.
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Support the implementation and optimization of enhanced client service models, including designated and dedicated team structures.
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Oversee audit readiness, accreditation activities, and quality governance programs.
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Partner across Product, Clinical, Operations, Sales, and Account Management to align strategy with service delivery.
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Support client retention, growth initiatives, and operational readiness efforts.
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Contribute to workforce planning, staffing strategy, financial stewardship, and operational efficiency initiatives.
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Monitor performance guarantees and support measurement and achievement activities.
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Lead and develop leaders across clinical and operational functions.
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Represent Clinical Operations in enterprise initiatives, strategic discussions, and client-facing activities, including RFPs and finalist presentations.
Scope and Impact
This role supports a large and complex population across high-value client relationships and operates with broad cross-functional influence. Responsibilities include balancing client experience, operational scalability, financial stewardship, and clinical performance in a dynamic healthcare environment.
The position requires strong strategic judgment, executive presence, and the ability to influence across matrixed teams while maintaining focus on operational execution.
Qualifications
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Active Unencumbered Registered Nurse (RN) license required.
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Minimum of 10 years of experience in healthcare operations, case management, or clinical program leadership.
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Demonstrated leadership experience in complex, matrixed healthcare organizations.
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Experience leading large operational teams with multiple levels of leadership.
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Strong knowledge of clinical operations, care management, and performance management.
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Proven ability to influence and collaborate across Product, Sales, Clinical, and Operations teams.
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Experience supporting strategic initiatives, operational transformation, or service model implementation.
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Strong communication, presentation, and executive stakeholder management skills.
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Intermediate to advanced technical skills using multiple systems.
Preferred Experience
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Experience supporting high-touch or differentiated client service models.
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Working knowledge of performance guarantees, client implementations, or operational governance initiatives.
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Demonstrated ability to lead through organizational change and evolving business priorities.
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Experience leading operational transformation and enterprise-wide initiatives.
Requirements
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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.
Benefits
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Annual salary of 144,200 - 240,400 USD / yearly, depending on relevant factors, including experience and geographic location.
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Eligible to participate in an annual bonus and long-term incentive plan.
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Comprehensive range of benefits, including medical, vision, dental, and well-being and behavioral health programs.
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401(k), company paid life insurance, tuition reimbursement.
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A minimum of 18 days of paid time off per year and paid holidays.
Company Description
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.
