Vice President, Utilization Management Products

6 months ago

Philadelphia, United States The Cigna Group Full time

The Vice President of EviCore UM Products will be responsible for the EviCore product suite. This role will lead the development and strategic direction of all products inclusive of Diagnostic Solutions (Rad, Card, Gastro), and conditioned based products of Oncology, Lab, Musculoskeletal, Sleep, DME, and Home Health. The role will also be responsible for focus on management of complementary capabilities such as Network Ops and Claims that deliver better value and experiences for the lives served resulting in better outcomes for our 100+ clients. The role will be responsible for driving significant year over year revenue and profit growth for the organization that manages 122M+ lives and engages 800K providers annually.

Essential Functions

  • Positioned as the leader in the organization for end-to-end ownership of the EviCore product suite.
  • Creates a positive culture that attracts, retains, and grows talent; willingness to lend talent to support initiatives across Evernorth as stretch opportunities. 
  • Collaborates with Technology and Operations on efficient solution design, development and adoption that aligns to client and provider needs.
  • Represent EviCore products in client-facing interactions including, but not limited to, client finalist meetings, advisory board forums, Evernorth client and consultant conferences, etc. 
  • Develop relationships with Evernorth clients that enable an outside-in approach to development and management of solutions.
  • Lead efforts with Growth/Account Management and Client Management leadership in analyzing the market to make strategic recommendations on the solution set.
  • Accountable for the performance of the portfolio to provide aligned value to clients, patients and providers. 
  • Influence decision makers across the organization to proactively evaluate the evolving needs of EviCore UM Solutions and maintain/enhance existing products. 
  • External lead to ensure product positioning is consistent with the overall organizational message.
  • Responsible for analyzing, improving and executing roadmap of products, capabilities, and strategic initiatives.

Qualifications

  • Bachelor’s degree required. MBA preferred.
  • At least 10 years of significant business/product development and/or product management experience.
  • Advanced problem-solving skills with the ability to work cross –functionally to resolve issues and generate results among potentially conflicting constituencies.
  • Embraces creativity to set a vision for the team in successful resolution of pressing issues.
  • Able to motivate and lead a team in fast paced and competitive environment.
  • Track record of developing new and innovative programs to address business needs.
  • Demonstrated ability to prioritize and mange a team’s workload and meet project deadlines.
  • Excellent communication skills, including presentations and negotiations.
  • Able to guide a team towards specific deliverables within an environment of tight deadlines and significant pressure.
  • Ability to handle complex analysis from issue identification to proposal of potential solutions.
  • Demonstrated ability to evaluate financial data and drive action to create additional value.
  • Strong business, financial, analytical and organizational skills.
  • Knowledge of Healthcare and PBM industry preferred.
  • Excellent customer service, technical, analytical, and communication skills required. 


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