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Director, Value- Care and Provider & Network Experience - Healthcare - Hybrid

Job in St. Louis, Saint Louis, St. Louis city, Missouri, 63105, USA
Listing for: Cigna
Full Time position
Listed on 2026-03-09
Job specializations:
  • Healthcare
    Healthcare Management, Healthcare Consultant, Healthcare Administration
Salary/Wage Range or Industry Benchmark: 100000 - 125000 USD Yearly USD 100000.00 125000.00 YEAR
Job Description & How to Apply Below
Position: Director, Value-Based Care Performance and Provider & Network Experience - Cigna Healthcare - Hybrid
Location: St. Louis

Position Summary

The Director of Value‑Based Care Performance and Provider & Network Experience is a senior clinical performance leadership role accountable for executing, measuring, and continuously improving clinical programs that drive patient outcomes, provider experience, and total cost of care. This role requires strong analytical and actuarial fluency applied to clinical decision‑making, outcome measurement, and performance accountability. The Director ensures that clinical initiatives are supported by clear measurement frameworks and financially sound business planning;

that outcomes are rigorously defined, evaluated, and reported; that findings are translated into actionable program refinements and operational improvements; and that results are distilled and disseminated to key internal and external audiences.

Working closely with clinical executives in the markets, provider organizations, and enterprise partners, the Director ensures that Value‑Based Care, Network, and Provider Experience initiatives are clinically credible, operationally effective, and financially sustainable. The role maintains primary accountability for clinical performance improvement and affordability impact and reporting.

Key Responsibilities

Provider Experience and Measurement

  • Support the execution and ongoing management of provider experience improvement initiatives, with ownership of outcome measurement and performance tracking
  • Develop and maintain provider experience measurement frameworks and partner with providers to interpret results and implement targeted improvement actions
  • Ensure provider‑facing reporting and performance tools are clinically meaningful and aligned with care delivery workflows
  • Maintain and oversee clinical scorecards (and other ad hoc business reporting needs) related to provider experience, access, and care delivery performance, ensuring measures support accountability and improvement

Value‑Based Care and Network Performance

  • Maintain operational responsibility for defining and measuring clinical performance outcomes and affordability impact across value‑based care and network clinical programs
  • Apply actuarial, financial, and clinical effectiveness analyses to evaluate clinical intervention performance, provider economic opportunities, and risk exposure in support of clinical program management, strategy, and business planning
  • Support the development and evaluation of test‑and‑learn initiatives, including tracking and ad hoc assessments needed for day‑to‑day business operations
  • Partner with finance, network, and clinical teams to implement performance improvement actions based on observed outcomes and evaluation findings
  • Oversee clinical pilots and improvement initiatives from implementation through evaluation, including defined success metrics and performance monitoring
  • Maintain awareness of policy and regulatory influences on cost and quality measurement to ensure compliance

Population Health Strategy and Measurement

  • Identify and manage key medical cost and utilization drivers through active oversight of population health initiatives and associated outcome measures
  • Establish and maintain population health measurement frameworks that use actuarial forecasts, trend analyses, and clinical data to monitor outcomes, utilization, and emerging risks
  • Ensure effective clinical programs are incorporated into routine performance monitoring, forecasting, and financial evaluation processes
  • Partner with market clinical executives to evaluate local initiative impact, refine intervention design, scale effective approaches, and discontinue low‑value activities
  • Oversee external population health partnerships to ensure tools and outputs directly support clinical evaluation and performance management in support of external provider partners

Evaluation and Dissemination

  • Ensure the rigorous evaluation of clinical and population health initiatives, assessing clinical effectiveness, affordability impact, operational performance, and strategic importance
  • Communicate and disseminate findings and lessons learned to support accountability and improvement
  • Support internal and external dissemination of clinical performance and…
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