Outpatient Clinical Operations Director

Cigna   •  

Phoenix, AZ

Industry: Healthcare


8 - 10 years

Posted 70 days ago

This job is no longer available.


The Regional Operations Leader will be a critical team member in transforming CMG into an innovative medical care provider promoting quality care and accessible services in an efficient and customer centric manner.

Reporting directly to, and working with the Chief Operating Officer (COO), this individual will be responsible for Regional Operations as well as a CMG strategic resource group to develop and execute the overall clinical operations strategy for maximization of performance. The successful candidate will be responsible and accountable for planning, coordinating, directing and monitoring all operational and financial aspects of the Region. The position will have a reporting structure of seven or more health care centers (HCCs) with 100-250 full-time employees and manage an operating budget between $110M and $130M. In diad partnership with the Regional Medical Director, he/she will provide effective leadership to managers, supervisors and clinical staff while overseeing the delivery of quality, cost-effective patient care.

Responsibilities and Essential Functions

  • The Operations Leader will monitor appropriate metrics and drive organizational performance around both long-term and short-term strategic objectives. Specific responsibilities include, but are not limited to:
  • Develops, reviews and monitors financial and performance outcomes to assure attainment of organizational objectives, including full accountability for Profit & Loss (P&L) performance and other operational targets within each region, reporting monthly variance exceptions and developing remedies for corrective actions, when needed. Fiscally responsible for achieving an acceptable level of profitability by continual operational effectiveness and well-defined clinical outcomes.
  • Provides leadership in development, implementation and oversight of medical group standards, programs and systems to achieve integrated strategic business initiatives, objectives and outcomes by enabling the business to achieve their objectives through the effective use of operating efficiencies.
  • Directs, supervises and evaluates leaders and support staff. Holds management accountable for achieving plans, strategic initiatives and performance targets. Partners to identify and resolve the most complex issues impacting initiatives and operations. Develops staff to ensure continued professional growth and to provide the competencies needed to support growth and long-term success. Fosters an environment of continuous quality improvement that focuses on processes and outcomes.
  • In a coordinated approach with Medical leadership, develops and implements procedures, policies and means of accountability that result in complete continuity of patient care – from in-patient to clinic, rehabilitation, home care, skilled nursing facilities and any emerging additional features of the wellness and healthcare continuum. Ensures controls are effective, efficient and compliant with laws and regulations.
  • Provides overall direction one CMG Strategic Resource Group across all regions, with responsibility to establishes specific direction and goals in support of and alignment with overall Cigna Medical Group strategies and ensure integration and coordination among all field operations and business units.
  • Partners with key Operations, Shared Services, Medical and Ancillary leadership to develop and help support a strategic growth plan that will help drive quality, collaboration and excellence within a clinical operating environment. Ensures execution of strategic priorities and achieves plan metrics.
  • Builds relationships with internal and external stakeholders and organizations through community involvement, promoting and sponsoring CMG products and services within local markets. Builds on-going strategic relationships with matrixes partners, network specialists, hospitals, ACOs, hospital programs and other partners within and outside CMG to ensure a high level of collaboration in order to develop partnerships, coordinate activities and resolve problems.
  • Collaborates with the COO and CMG’s senior leadership team (SLT) to develop and implement a clinical operations strategy, business plan, operating structure, and capital allocation plan consistent with the broader strategy, plans and goals of the Medical Group.
  • Monitors the impact of targeted growth of the facility’s existing space plan based on projected membership enrollment, visits and utilization. Propose, plan and direct facility expansion and enhancement projects when required.
  • Ensures a strong “customer centricity” focus throughout CMG Clinical Operations, with a monitoring component to provide feedback for SLT review. Further, ensures processes are in place to response to patient complaints and resolve problems leading to the complaints.
  • Collaborates with local Cigna leadership on CMG product development, network improvements, financial, quality and physician performance and engagement opportunities.
  • Initiates revenue and cost management strategies; including oversight and ownership of the successful implementation of these strategies.
  • Other related duties as assigned

Minimum Qualifications

  • BS in Business Administration, Finance or Health Care Administration
  • Masters in Business Administration, Public Health, Healthcare Administration preferred
  • Seven to ten years leadership experience, preferably within a large outpatient clinical organization with multi-site responsibilities.
  • Experience in a complex healthcare delivery environment, including clinic operations, financial management, quality management, risk management and business growth and development, preferably within a large medical group.
  • Excellent leadership skills including ability to think strategically, develop vision and execute for results.
  • Knowledge of regulatory and compliance healthcare requirements.
  • Proven ability to drive organization innovation and change.
  • Experience working in a large highly matrixed organization, with proven ability to develop internal enterprise relations and external relationships within the medical community.
  • Excellent presentation and communication skills.
  • Ability to make sound business decisions by analyzing financial and quality metrics as well as develop practical solutions for metric goal deviations.
  • Strong business and financial background with a sense of urgency and a desire to achieve top line results.