Chief Medical Officer

Cigna   •  

Nashville, TN

Industry: Healthcare

  •  

8 - 10 years

Posted 39 days ago

POSITION SCOPE:

The Chief Medical Officer (CMO) of Cigna Medicare Advantage will report to the President of Cigna Medicare Advantage and is a member of the Cigna Medicare Advantage and Cigna Government Business Senior Leadership Teams. The CMO is the Senior Clinical Executive for all Cigna Medicare Advantage lines of business, and will work closely with the Chief Medical Officer of Cigna by participating in the CMO's Senior Leadership meeting to facilitate a unified approach for all of Cigna's businesses.

The CMO leads the overall clinical vision for Cigna Medicare Advantage. The CMO along with his/her National Senior Medical Director Leadership Team, in partnership with our clinical operation teams, has accountability for driving excellent results for all clinical affordability, quality, population health, STARs, growth, Net Promoter Score (NPS), value-based care, and external relationship initiatives for the organization. This leader will have direct oversight of all physicians supporting our:

  • Market Provider Relationships
  • Utilization Management
  • Appeals
  • Part D
  • Behavioral Health
  • Quality and Population Health
  • Medical Innovation & Policy
  • Clinical Care Management

In addition, it will oversee our national Clinical Quality and Clinical Program teams, our Living Well Clinics, and embedded and Mid-Atlantic hospitalist programs.

The CMO delivers the clinical value proposition focused on quality, affordability and service, in support of the sales and growth activities of the Cigna Medicare Advantage including conducting Broker/Client presentations and participating in customer consultations and national medical and industry meetings. The CMO represents the voice of the customer in benefit design. S/he actively promotes positive relations with CMs, State/Local regulatory authorities and Medical Societies.

The CMO leads the clinical interface with health care providers and Cigna Medicare Advantage network management colleagues in efforts to transform the health care ecosystem including, but not limited to, Cigna CAC's, value-based contracting, clinical practice transformation, patient-centered medical homes, cost transparency initiatives, creative care management programs, high-performance networks, consumer engagement, value-based benefit designs and the and financial goals for Cigna Medicare Advantage.

KEY RESPONSIBILITIES:

- Clinical leader of Cigna Medicare Advantage, working as member of Cigna Medicare Advantage & Cigna's Government Segment Senior Leadership teams to drives clinical strategy.

- Manages and leads the National Senior Medical Directors and acts as a mentor in the development of skills related to their job.

- Accountable for clinical outcomes for Cigna Medicare Advantage and Chairs both the Medical cost trend committee (MCTC) and the Medicare Advantage Affordability Committee. (MAAG)

- Collaborate with Cigna Chief Medical Officer to align and leverage resources.

- Clinical face of Cigna Medicare Advantage public relations and with CMS.

- Responsible for providing clinical expertise and business direction to manage the total cost of care for the Cigna Medicare Advantage customers, client, providers and the organization.

- Strategic development of clinical value-based care initiatives.

- Unifies all clinical functions of Cigna Medicare Advantage to provide outstanding quality, affordability, and personalization for our customers and ensure Cigna Medicare Advantage is the partner of choice to providers.

- The Chief Medical Officer acts as an improvement catalyst for all quality-related efforts including CMS Star initiatives.

- Drives clinical innovation through constructive disruption.

5 Necessary Competencies for CMO (Chief Medical Officer)

  • Strategic Thinking, Strategic Scanning. As the business of health care moves beyond the traditional paradigms of care delivery, so leaders must apply new approaches and perspectives to solve problems. Looking beyond the old ways of doing business requires leaders to look beyond traditional boundaries to explore the new. Strategic thinkers are future-based, curious, long-term-focused, willing to take risks, able to prioritize, and both nimble and creative. Able to execute strategies through people by providing leadership, feedback, coaching, utilizing influence, managing conflict, and developing talent for long-term success.
  • Execution. This competency involves using appropriate methods of influence (formal and informal) to motivate colleagues and stakeholders into action for accomplishing needed tasks and objectives. It also includes knowing how to create focus around key priorities (right work) and building the capability (right people) to deliver results (great results). Good strategy is worthless if it cannot be executed. Good execution also requires a discipline of governance and evaluation to understand what is working and what is not — using data to make necessary changes to improve results. Ability to Lead Strategic Execution.
  • Visionary and Adaptive Leadership. This competency involves executing vision based on both current and future possibilities, and they inspire their teams to adapt and thrive in a changing environment. The qualities of a visionary and adaptive leader include openness, imagination, persistence, conviction and the ability to lead a meaningful process of change in a purposeful manner. Demonstrated thought leadership.
  • Business Acumen. The keenness and quickness in understanding and dealing with a business situation in a manner that is likely to lead to a good outcomes. Proven results /experience working within Medicare Advantage in a corporate environment is required. A deep and applicable understanding of the system of how a business achieves its goals and objectives. It includes a thorough understanding of the levers that create and position a value proposition to customers and it drives profitability, cash flow, and shareholder value. Specifically, the understanding and awareness of how to think about and successfully make the right business decisions.
  • Analytical Thinking. Leverage data to identify and define problems, extract key information from data/ analytics and develop workable solutions for the problems identified in order to test and verify the cause of the problem and develop solutions. Process a Data Driven mind set and approach when making decisions based on foundational analytics and driving results by monitoring and tracking outcomes vs goals.

REQUIRED SKILLS:

- Degree in Medicine from an accredited school and is licensed to practice medicine (Doctor of Medicine or Doctor of Osteopathic Medicine); MBA /advanced business degree preferred.

- Board Certified in an ABMS or AOBMS specialty.

- Minimum of five years clinical practice experience; strong knowledge of managed care industry.

- Strong leadership experience leading large groups of medical professionals- Minimum 7 – 10 years

- Proven record of executive leadership and clinical management in the Medicare Advantage setting; able to work in matrixed organization.

- Proven ability to develop relationships with network and community physicians and other providers; visibility and involvement in the national medical community.

- Ability to work within changing business environment and balance patient advocacy with business needs.

- Drive change and innovation though continually seeking and implementing innovative solutions.

- Excellent interpersonal, communication and presentation skills with ability to influence in executive settings for both clinical and non-clinical audiences.

- Solid data analysis and interpretation skills and ability to focus on key metrics.

- Proven ability to execute and drive improvements against stated goals.

- Strategic thinking with proven ability to communicate a vision and drive results; able to see ahead to future possibilities and translating them into breakthrough strategies.

- Experience with managing multiple projects in a fast-paced matrix environment.

- Demonstration of strong and effective abilities in teamwork, negotiation, conflict management, decision-making, and problem solving skills.

- Successful ability to assess complex issues, to determine and implement solutions, and resolve problems.

- Success in creating and maintaining cooperative, successful relations with diverse internal and external stakeholders.

- Demonstrated sensitivity to culturally diverse situations, participants, and customers/members.

- Ability to actively manage financial performance and ensure accountability for results.

- Strong team player and team building skills.

- Instills trust by gaining the confidence and trust of others through honesty, integrity, and authenticity.