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The Medicare Affordability Director serves as the strategic leader responsible for designing and activating innovative solutions across the Medicare organization that focus on total cost of care - all focused on delivering affordable, high-quality, and competitive solutions to the market. This critical role on the Medicare Performance Optimization team will be accountable for financial performance improvements through strategic/operational leadership for continuous improvement of organizational excellence for the development and execution of the medical cost management and strategy.
This leader will be responsible for shaping and influencing program and value stream strategy, along with plans designed to ensure Cigna’s Medicare programs meet key business performance goals. Areas of focus will include optimizing our population health management and access to care initiatives, identifying Medicare-specific needs for clinical support, UM, site of care and other medical and behavioral management areas, while connecting, influencing and leading across the organization in order to develop key partnerships with our enterprise teams focused on total cost of care initiatives.
The role will collaborate with a wide array of cross-functional partners and their actions have significant impact on key business objectives. You create the opportunity to provide thought leadership and business expertise across multiple disciplines, and is intended to be recognized internally as “the go-to person” for the most complex strategic affordability assignments.
**Key Responsibilities**:
- Support continued refinement of a cross-functional, matrixed governance structure to support Affordability initiatives across Clinical, Network, Operations, OpEx, Performance Office, Pharmacy, Local Markets, Enterprise Affordability and other key domains
- Lead the Medicare Affordability team and facilitate meetings to communicate and socialize the refreshed affordability strategies and plans with business and portfolio leaders throughout the organization
- Collaborates closely with colleagues across the Medicare team as well as matrix partners and leaders across the broader organization.
- Consults on the implementation of key affordability initiatives, mapping initiatives to the enterprise affordability strategy and identifying opportunities to scale. Socializes the impact of key healthcare affordability initiatives with Medicare leadership and stakeholders.
- Partner with functional teams to implement cost-containment goals, objectives, metrics, and Return on Investment (ROI) targets for affordability programs.
- Partner with Competitive Intelligence, Enterprise Affordability, Medical Economics, Finance, Data and Analytics, Product, Network, Clinical, Quality, and local markets to better understand needs of our current and future customers, to identify programs that provide differentiated value and Affordability savings
- Define processes and governance to identify and evaluate prospective external partners / solutions with potential to drive Affordability savings and reduce total cost of care. Drive ideation, exploration, and prioritization of initiatives and work with Affordability team members to ensure implementation and sustainability.
- Lead the portfolio process inclusive of prioritization, trade-off, and funding decisions for affordability initiatives.
- Proactively identify and address barriers; translate care and cost trend findings to potential gaps in current state solutions and develop actionable strategies to improve access and affordability for Cigna Medicare members and stakeholders.
- Identification of barriers to success of programs, working closely with other leaders within the company to develop and implement plans to improve approaches and/or overcome obstacles to improvement.
- Promotes interdepartmental integration and collaboration to enhance clinical programs and services, as well as understanding, communication, and coordination of all optimization program components.
- Leads strategic change initiatives, unlocking affordability and growth improvements.
- Possess flexibility and agility to handle multiple priorities simultaneously and adapt to new assignments/responsibilities as the business matures.
**Qualifications**:
- The Affordability Director will have a Bachelor’s degree (Master’s preferred)
- 10+ years of leadership within a large matrixed organization within the healthcare space and understanding of how the health network and matrix partners work together
- Strong financial acumen required
- Demonstrated thought-leadership and the ability to identify and solve challenges with innovative solutions.
**Functional**:
- Experienced operations and strategy leader with a deep understanding of health plan management processes and strategies and experience with Medicare programs.
- Deep knowledge of managed care industry trends, developments, and challenges
- Experience in medical cost management initi
