Partnerships & Controls Director

Partnerships & Controls Director, Provider Organisation IHDS Cigna International Health Position Summary

This role is responsible for designing and executing robust control frameworks, performance oversight, and partnership standards for the Provider Organisation across international markets. The Partnerships & Controls Lead ensures operational integrity, quality delivery, and support for annual savings targets while enhancing effectiveness across Pre‑Authorization, Claims Management, Reconciliation, Network and Counter Fraud, Waste and Abuse functions. The role partners closely with senior leadership and cross‑functional teams to strengthen accountability, improve performance, and enhance collaboration with TPAs, Cigna Links, and external partners.

• Design and implement control frameworks that reinforce accountability, sound decision‑making, and operational integrity across functional areas.
• Lead closed file review (CFR) campaigns and drive continuous process improvements across Provider, Member and Clinical domains.
• Implement quality assurance initiatives and ensure adherence to internal standards and expectations.

• Develop and maintain financial and operational control mechanisms to support IH and IHDS annual savings targets.
• Monitor savings performance, identify delivery risks, and guide corrective actions.
• Provide senior leadership with clear reporting on control effectiveness, performance trends, and risk exposure.

• Establish controls and standards for resource allocation, capacity planning, and alignment with strategic priorities.
• Validate workforce and vendor utilisation relative to approved budgets and operational requirements.
• Monitor forecasting processes and escalates risks to delivery or quality.

• Develop health services control structures that promote evidence‑based practices and cost‑effective care delivery across markets.
• Collaborate with medical directors and health services teams to enhance utilization management, case management, and quality improvement programs.
• Support initiatives that reduce avoidable medical costs and strengthen overall health outcomes.

• Define control standards for provider contracting, partnership agreements, and Cigna Links operational oversight.
• Validate adherence to contractual obligations and performance expectations.
• Monitor KPIs, identify performance gaps, and communicate actions needed to leadership.

• Establish control standards for provider call centre operations, GOP, claims management, and reconciliation processes.
• Collaborate with Strategy & Transformation to automate workflows and strengthen system validation rules to improve customer & provider experience.
• Monitor dashboards, identify operational risks, and elevate concerns appropriately.

• Establish operational and analytical controls for PI programs to ensure effective fraud, waste and abuse safeguards.
• Validate and refine detection, sampling, analytics, and recovery methods for accuracy and effectiveness.
• Review performance reporting and highlight control weaknesses requiring intervention.

• High visibility with International Health SLT, CEOs, COO IHDS, IHDS SLT.
• Opportunity to shape global partnership and control standards across markets.
• Meaningful influence on operational strategy and performance improvement across international regions.

• Bachelor’s degree required; advanced degree preferred (healthcare administration, business, or clinical discipline).
• Significant experience in the health insurance industry including leadership roles in multi-disciplinary operations.
• Proven experience designing and monitoring operational and financial controls tied to performance outcomes.
• Strong understanding of provider contracting, operational process design, and partnership frameworks.
• Demonstrated accountability with ability to drive execution individually and through teams.
• International experience and cross cultural fluency is essential.
• Excellent…