Senior Advisor, Care Model & Payment Innovation - The Cigna Group - Hybrid
Cigna · Connecticut
📍 CT, Bloomfield, 900 Cottage Grove Rd Wilde Bldgvia workday
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Summary: The Senior Advisor, Care Model & Payment Innovation is a senior individual-contributor role focused on the design, strategy, policy advancement, partnership development, and pipeline enablement of Cigna Healthcare and Evernorth’s care delivery and alternative payment innovation agenda. This role supports the development of market-relevant care model and payment concepts and strategic partnerships across Cigna Healthcare and Evernorth stakeholders, including providers, employers, health plans, enablers, disruptors, pharmaceutical manufacturers, pharmacies, PBMs, specialty pharmacy, and intermediaries.
The role helps shape strategic partnerships, build and manage an innovation pipeline, evaluate external market opportunities, and strengthen relationships with intermediaries and high-performing provider partners, accelerating strategy development, partnership readiness, and execution alignment across markets and business units. The role also provides close linkage to ongoing market innovation driven by governmental and regulatory bodies and partners closely with Data & Analytics to model, evaluate, and prioritize care model and payment innovation opportunities.
T he ideal candidate for this position is a value based care content expert who is organized, well versed in project management , can conceptualize and execute each step in a strategic plan, and is effective in navigating complex and highly matrixed organizations.
Responsibilities:
Under the direction of the Medical Senior Director of Care Model and Payment innovation, this individual will:
Manage complex new initiatives from inception to pilot
Create and follow a detailed project plan using standard project management tools
Communicate expectations and deadlines, then h old internal and external stakeholders accountable to them
Effectively engage the diverse internal stakeholders to effectively execute these projects, including but not limited to data analytics, product teams, contracting teams, and operational leaders
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 years plus 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 assump
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