Stars & Risk Adjustment Performance and Solutions Enablement Senior Advisor- Hybrid- Cigna Healthcare- CT, PA, TN, AL, TX, or MO

1 month ago

Nashville, Tennessee, United States The Cigna Group Full time

Job Summary:

This position will focus on Stars and Risk Adjustment (RA) performance and solution enablement activities, with an emphasis on process improvement and automation opportunities, vendor efficiencies, and business critical program and solution support. This role will establish alignment amongst Stars and RA leadership and key matrix partners to ensure we continue to meet the needs of our Stars and RA goals and objectives. This position reports to the Managing Director of Stars, Risk Adjustment, and Interoperability.

The successful candidate for this role will be a self-starter, intellectually curious, and bring the ability to manage complex workstreams while synthesizing essential updates and strategies for a senior executive-level audience. This individual also is comfortable with ambiguity and creating structures to mitigate along with ability to quickly pivot according to organizational priorities.

Core Responsibilities:

Process Improvement and Automation Opportunities

  • Continually analyze current Stars and RA processes to ensure efficiency and accuracy optimization, including but not limited to automation opportunities, workflow redesign, and staffing requirements.
  • Assist in driving Cigna Medicare interoperability advancement, working with Stars and RA leadership to identify crucial areas of immediate and long-term opportunities while supporting roadmap creation and execution.
  • Support other internal and external Stars and RA performance and solution management processes as needed.

Business Critical Program and Solution Support

  • Support special projects or broader initiatives that drive Stars and RA performance improvement and program execution.
  • Drive more strategic changes broadly across Cigna MA, jointly for Stars and RA, that align and support performance improvement opportunities.
  • Strategize with Stars and RA leads and matrix partner leaders to identify opportunities for collaboration and scope out potential cross-business projects.
  • Partner with Stars and RA leadership and vendor owners to ensure vendors are meeting our business needs along with assessing where gaps remain and/or where there is potential duplication of efforts, monitor performance at the overall team level, and ensure timely budget updates.

Minimum Qualifications:

  • Bachelor's degree requested – Masters preferred
  • 5 or more year's health care experience, preferably in CMS Stars, Risk Adjustment Prospective Programs, clinical quality, healthcare quality improvement.
  • Excellent written and verbal communication with public speaking experience
  • Strong performance management skillset
  • Analytic and problem-solving capability
  • Experience leading and executing large strategic projects designed to enhance operating effectiveness and drive change
  • Experience working in a highly matrixed environment
  • Proficiency in Microsoft Office applications (Outlook, Word, Excel, Power Point, etc.), including experience running web-based meeting

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.

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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 require reasonable accommodation in completing the online application process, please email: for support. Do not email for an update on your application or to provide your resume as you will not receive a response.

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.

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