Description
The Clinical Strategy Leader will report to the Associate Chief Medical Officer for Clinical Product and Solution Design and support the development and execution of Cigna Healthcare's strategy for members with high-risk and complex care needs.
Responsibilities:
- Support development and execution of Cigna Healthcare's strategy for high-risk and members with complex care needs, including oncology, high drug spend, serious illness, specialty pharmacy needs, and complex chronic conditions.
- Translate clinical and business priorities into strategic roadmaps, business cases, implementation plans, and measurable performance goals.
- Lead the design of scalable clinical programs for high-risk and complex populations, including identification, engagement, navigation, escalation, care coordination, and longitudinal support.
- Lead development of digital and AI-enabled solutions for high-risk members, including AI agents, advanced segmentation, proactive outreach, member-facing navigation, clinician workflow support, and next-generation case management capabilities.
- Partner with Product, Technology, Data, Clinical Operations, Pharmacy, Analytics, Finance, and market-facing teams to identify priority use cases, define requirements, and support execution through implementation.
- Use data, analytics, claims insights, clinical and pharmacy trends, operational performance, and client needs to identify opportunities and prioritize initiatives.
- Improve case management and complex care models, including structured case review processes, high-risk case management, and targeted interventions for priority populations.
- Develop performance measurement frameworks, including KPIs related to clinical outcomes, affordability, member experience, engagement, operational efficiency, clinician adoption, and client value.
- Drive process improvement and operating model enhancements to improve scalability, consistency, and execution discipline.
- Align stakeholders across a matrixed organization to establish shared priorities and drive improved business outcomes.
- Prepare executive-ready strategy documents, updates, recommendations, and decision materials for senior leadership.
- Lead cross-functional teams and workgroups through complex initiatives, fostering accountability and collaboration.
- Bring an outside-in perspective on clinical innovation, digital health, AI-enabled care models, oncology, specialty pharmacy, high-cost therapies, GLP-1s, gene therapy, and other emerging areas relevant to clinical product strategy.
- Help ensure digital, AI-enabled, and clinical solutions are clinically sound, member-centered, operationally feasible, financially grounded, measurable, and aligned with responsible innovation principles.
Qualifications:
- Active and unrestricted Medical License in State (MD/DO)
- Current Board Certification in an ABMS or AOA recognized specialty
- Minimum 3 years of clinical practice experience
- Experience in strategy development and implementation for health care-related organizations, including payer, provider, pharmacy, clinical services, health services, consulting, digital health, or related sectors.
- Experience developing clinical programs and driving successful execution from concept through implementation, adoption, and measurable outcomes.
- Strong business and/or consulting experience, including ability to structure complex problems, synthesize insights, develop recommendations, and translate strategy into action.
- Solid business and financial acumen, with ability to connect clinical initiatives to affordability, value creation, operational performance, client needs, and enterprise impact.
- Experience using analytics, data, and performance insights to identify opportunities, shape strategy, guide decision-making, and measure outcomes.
- Experience leading teams or cross-functional workgroups to execute complex projects in a matrixed environment.
- Process improvement experience, including ability to improve workflows, operating models, execution processes, and scalable program delivery.
- Ability to influence stakeholders, establish alignment, and drive improved clinical, operational, financial, and business outcomes.
- Strong executive communication skills, including ability to translate complex clinical, operational, financial, analytical, and technical topics into clear, concise, leadership-ready materials.
- Digital and AI fluency, including ability to partner with Product, Technology, Data, and Clinical teams to develop AI-enabled and digital solutions for high-cost claimants, including AI agents, advanced segmentation, proactive engagement tools, and technology-enabled case management workflows.
Benefits:
- Comprehensive range of benefits, including medical, vision, dental, and well-being and behavioral health programs
- 401(k)
- Company-paid life insurance
- Tuition reimbursement
- Minimum of 18 days of paid time off per year
- Paid holidays and leaves of absence