RN Clinical Program Sr. Advisor. Northeast New York, New Jersey or Connecticut Area - Hybrid

General Purpose:

Cigna's mission is to improve the health, well-being and sense of security for those we serve.

The Clinical Sales and Network 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.

Role Summary

The Clinical Program Sr Advisor, as part of the Clinical Sales and Network 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 Managementand 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, ...