Network Medical Executive - West Coast
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AI Summary
Medical Executive
Clinical Network & Provider Relations
Cigna Healthcare
Region: West Coast
Position Summary
The Medical Executive, Network & Provider Relations serves as a strategic physician leader responsible for improving healthcare affordability and network performance through provider engagement, clinical leadership, value-based care execution, and data-informed collaboration across assigned markets and provider organizations.
This role leverages clinical expertise, market intelligence, trusted provider relationships, and performance insights to influence care delivery, reduce avoidable cost and variation, support network strategy, and strengthen collaboration between Cigna Healthcare and the provider community.
Role Snapshot
Primary Purpose
Improve affordability, network performance, provider collaboration, and clinical value through physician leadership and provider influence.
Primary Partners
Network, contracting, provider relations, market leadership, clinical operations, analytics, actuarial, finance, and provider organizations.
Operating Model Alignment
Participates in Network & Provider Relations special projects to promote consistency, knowledge sharing, and operational excellence.
Role Orientation
Market-facing physician leader with responsibility for translating relationships and insights into measurable affordability and network outcomes.
Primary Responsibilities
Affordability & Network Performance Leadership
Serve as a physician leader supporting affordability, trend, and network performance objectives within assigned markets and provider relationships.
Use provider relationships, market intelligence, and performance data to identify opportunities to improve cost, quality, utilization, access, and overall network performance.
Partner with provider organizations to address clinical and operational drivers of healthcare trend, unnecessary variation, and avoidable cost.
Support implementation of evidence-based initiatives that improve value, strengthen outcomes, and promote appropriate site-of-care, specialty, and referral management strategies.
Collaborate with analytics, actuarial, network, finance, and clinical partners to evaluate opportunities, define interventions, and assess performance improvement.
Provide clinical leadership in addressing emerging affordability risks, provider performance opportunities, and strategic network priorities.
Provider Engagement & Influence
Develop and maintain trusted executive-level relationships with health systems, physician organizations, specialty groups, and independent providers.
Serve as a credible clinical advisor and strategic partner to provider leadership on performance improvement, collaboration, and network priorities.
Facilitate productive dialogue regarding affordability opportunities, provider performance, value-based care, quality outcomes, and clinical collaboration.
Gather provider insight and market intelligence to inform internal decision-making, escalation management, and strategic planning.
Support resolution of complex provider concerns, escalations, and relationship opportunities while maintaining alignment with organizational goals.
Value-Based Care & Clinical Transformation
Support growth, execution, and optimization of value-based care initiatives and provider performance programs.
Collaborate with providers, contracting teams, and clinical partners to improve quality, affordability, patient outcomes, and provider accountability.
Promote provider adoption of care delivery models and population health strategies that support improved performance and customer value.
Identify barriers to provider success and help connect providers with appropriate clinical, operational, and analytic resources.
Network Strategy Support
Provide clinical consultation and market insight for network strategy, provider partnerships, and contracting activities.
Assist in evaluating provider organizations, market opportunities, strategic partnerships, and performance improvement opportunities.
Support initiatives designed to strengthen network competitiveness, provider collaboration, and clinical alignment.
Identify opportunities to enhance provider alignment with organizational goals and market-specific priorities.
Success Measures
Performance will be evaluated based on contributions to the following outcomes:
Outcome Area
Examples of Expected Contribution
Affordability improvement
Identification, support, and execution of opportunities that reduce avoidable cost and improve value.
Network performance enhancement
Clinical leadership that supports access, quality, utilization, provider performance, and competitive network strategy.
Provider engagement effectiveness
Trusted provider relationships that enable productive collaboration and measurable improvement.
Value-based care execution
Support for provider alignment, performance improvement, and clinical transformation in value-based arrangements.
Issue resolution and escalation management
Timely, clinically grounded support for complex provider concerns and relationship risks.
Special projects contribution
Meaningful contributions to NPR special projects, tools, resources, best practices, and operational consistency.
Cross-functional leadership
Strong partnership across network, contracting, clinical, analytics, market, and finance teams.
Qualifications
Required
MD or DO degree.
Active, unrestricted medical license.
Board certification in an ABMS-recognized specialty.
Minimum 5 years of clinical practice experience.
Minimum 3 years of healthcare leadership, payer, network, provider relations, or value-based care experience.
Demonstrated ability to influence physician leaders, provider executives, and cross-functional partners.
Strong understanding of healthcare economics, clinical quality, utilization, population health, and performance improvement.
Exceptional communication, presentation, relationship-building, and executive presence skills.
Ability to operate effectively in a highly matrixed, fast-paced, and evolving environment.
Preferred
Experience with provider network management, contracting support, or provider performance strategy.
Experience with value-based care arrangements, quality improvement, or population health operations.
Experience with healthcare affordability initiatives, trend management, analytics, or financial performance improvement.
MBA, MHA, MPH, or equivalent business experience or training.
Experience leading cross-functional projects, peer learning forums, or team-based operating model initiatives.
Core Competencies
• Affordability Leadership
• Network Performance Management
• Provider Influence
• Value-Based Care Expertise
• Strategic Thinking
• Business Acumen
• Executive Presence
• Data-Informed Decision Making
• Change Leadership
• Matrix Leadership
• Clinical Credibility
• Collaboration & Partnership Development
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 212,600 - 354,300 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.
At The Cigna Group, 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), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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 need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.
The Cigna Group 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.
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