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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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