Senior Advisor, Care Model & Payment Innovation - The Cigna Group - Hybrid

Responsibilities

• Under the direction of the Medical Senior Director of Care Model and Payment innovation, this individual will be responsible for: Strategic Positioning, Market Strategy & Pipeline Development Build and manage a pipeline of partnership and model opportunities across pharmacy, specialty, provider, employer, and health plan stakeholders Assess market dynamics, competitive positioning, regulatory considerations, operational feasibility, and data requirements to inform prioritization Translate client needs and affordability opportunities into actionable innovation concepts Partnership Development & Relationship Building Identify and assess external partnership opportunities with intermediaries, high-performing providers, enablement platforms, pharmacies, pharmaceutical manufacturers, and specialty care partners Support relationship-building strategies that strengthen Cigna Healthcare and Evernorth’s position with key market intermediaries and provider partners in support of payment and care model innovation Contribute to partnership models that align incentives, improve outcomes, and support total cost of care management Model Development & Risk Management Support development of partnership and payment models with appropriate attention to compliance, regulatory, legal, and policy considerations Coordinate with Compliance, Legal, Data & Analytics, and business stakeholders to identify risks, constraints, required guardrails, and model assumptions early in design Ensure innovation concepts account for manufacturer interaction requirements, pharmacy and PBM dynamics, data use considerations, and applicable market rules Frame trade-offs and escalation needs clearly for leadership decision-making Care Model & Payment Innovation Design Support Support the design of advanced care delivery models and payment structures across primary care, specialty care, pharmacy-enabled care, and value-based prescribing opportunities Partner with Data & Analytics to model, evaluate, and prioritize care model and payment innovation opportunities, including opportunity sizing, target populations, performance assumptions, and evaluation metrics Translate clinical, operational, financial, data, and market insights into structured frameworks and executive-ready recommendations Shape pilots by defining hypotheses, target populations, stakeholder roles, metrics, and evaluation approaches Support high-performing provider strategies that differentiate provider engagement, incentives, enablement, and performance expectations Define strategy and roadmaps to scale successful payment and care models sustainably Cross-Enterprise Stakeholder Alignment & Execution Support Align stakeholders across pharmaceutical manufacturer strategy, pharmacies, PBMs, specialty pharmacy, providers, employers, and health plans Translate strategy into implementation pathways, sequencing, governance needs, and execution decision points Consulting-Style Problem Solving & Executive Synthesis Structure ambiguous problems and develop decision-ready recommendations for senior leaders Synthesize inputs into clear strategic options, trade-offs, risks, and recommended next steps Develop executive-level materials, leadership briefings, and Board-ready narratives that connect strategy, partnership value, compliance considerations, and execution readiness Qualifications: Bachelor’s degree or relevant experience required
• advanced degree preferred 5-7 plus years of relevant healthcare, strategy, consulting, pharmacy, managed care, provider, PBM, or life sciences experience Experience with value-based care, alternative payment models, pharmacy strategy, specialty care, or outcomes-based contracting preferred Strong problem-solving, stakeholder management, and executive communication skills Ability to operate effectively across complex, matrixed, and regulated healthcare environments Ability to partner with Data & Analytics teams to model opportunities, define assumptions, evaluate performance, and translate findings into strategic recommendations Strategic thinking and structured problem solving Partnership orientation and relationship-building capability Market awareness across pharmacy, PBM, specialty pharmacy, provider, employer, and health plan stakeholders Compliance-aware judgment and risk framing Data-informed opportunity modeling, evaluation, and prioritization Pipeline development and opportunity prioritization Ability to operate in complex, cross-functional environments Executive presence and communication Conceiving of and executing complex projects on a clear and defined timeline Preferred Qualifications: Experience supporting care model, payment innovation, value-based prescribing, pharmacy, PBM, specialty pharmacy, or provider partnership initiatives Familiarity with Evernorth capabilities, including pharmacy, PBM, specialty pharmacy, care delivery, and provider-facing services Experience working with or across pharmaceutical manufacturers, pharmacies, providers, employers, health plans, or market intermediaries Desired experience working with intermediaries in the primary or specialty care space, including enablement platforms, management services organizations, or other organizations supporting value-based care execution Desired experience working with state or federal policy in the design and execution of value-based care models Experience translating strategy into partnership pipelines, pilots, business cases, or implementation roadmaps Experience using data, analytics, and performance measurement to assess care model and payment innovation opportunities Familiarity with compliance, legal, or regulatory considerations relevant to healthcare partnerships and pharmaceutical manufacturer interactions *We will consider qualified applicants who are looking to work 100% remote instead of hybrid.
• 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 116,200 - 193,600 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 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 The Cigna Group Doing something meaningful starts with a simple decision, a commitment to changing lives.
• At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve.
• Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients.
• 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.