Network Medical Executive

Job description

Medical Executive Clinical Network & Provider Relations Cigna Healthcare Region: West Coast Position Summary The Medical Executive, Network & Provider Relations serves as a strategic physician leader responsible for improving healthcare affordability and network performance through provider engagement, clinical leadership, value-based care execution, and data-informed collaboration across assigned markets and provider organizations. This role leverages clinical expertise, market intelligence, trusted provider relationships, and performance insights to influence care delivery, reduce avoidable cost and variation, support network strategy, and strengthen collaboration between Cigna Healthcare and the provider community. Role Snapshot Primary Purpose Improve affordability, network performance, provider collaboration, and clinical value through physician leadership and provider influence. Primary Partners Network, contracting, provider relations, market leadership, clinical operations, analytics, actuarial, finance, and provider organizations. Operating Model Alignment Participates in Network & Provider Relations special projects to promote consistency, knowledge sharing, and operational excellence. Role Orientation Market-facing physician leader with responsibility for translating relationships and insights into measurable affordability and network outcomes. Primary Responsibilities Affordability & Network Performance Leadership Serve as a physician leader supporting affordability, trend, and network performance objectives within assigned markets and provider relationships. Use provider relationships, market intelligence, and performance data to identify opportunities to improve cost, quality, utilization, access, and overall network performance. Partner with provider organizations to address clinical and operational drivers of healthcare trend, unnecessary variation, and avoidable cost. Support implementation of evidence-based initiatives that improve value, strengthen outcomes, and promote appropriate site-of-care, specialty, and referral management strategies. Collaborate with analytics, actuarial, network, finance, and clinical partners to evaluate opportunities, define interventions, and assess performance improvement. Provide clinical leadership in addressing emerging affordability risks, provider performance opportunities, and strategic network priorities. Provider Engagement & Influence Develop and maintain trusted executive-level relationships with health systems, physician organizations, specialty groups, and independent providers. Serve as a credible clinical advisor and strategic partner to provider leadership on performance improvement, collaboration, and network priorities. Facilitate productive dialogue regarding affordability opportunities, provider performance, value-based care, quality outcomes, and clinical collaboration. Gather provider insight and market intelligence to inform internal decision-making, escalation management, and strategic planning. Support resolution of complex provider concerns, escalations, and relationship opportunities while maintaining alignment with organizational goals. Value-Based Care & Clinical Transformation Support growth, execution, and optimization of value-based care initiatives and provider performance programs. Collaborate with providers, contracting teams, and clinical partners to improve quality, affordability, patient outcomes, and provider accountability. Promote provider adoption of care delivery models and population health strategies that support improved performance and customer value. Identify barriers to provider success and help connect providers with appropriate clinical, operational, and analytic resources. Network Strategy Support Provide clinical consultation and market insight for network strategy, provider partnerships, and contracting activities. Assist in evaluating provider organizations, market opportunities, strategic partnerships, and performance improvement opportunities. Support initiatives designed to strengthen network competitiveness, provider collaboration, and clinical alignment. Identify opportunities to enhance provider alignment with organizational goals and market-specific priorities. Success Measures Performance will be evaluated based on contributions to the following outcomes: Outcome Area Examples of Expected Contribution Affordability improvement Identification, support, and execution of opportunities that reduce avoidable cost and improve value. Network performance enhancement Clinical leadership that supports access, quality, utilization, provider performance, and competitive network strategy. Provider engagement effectiveness Trusted provider relationships that enable productive collaboration and measurable improvement. Value-based care execution Support for provider alignment, performance improvement, and clinical transformation in value-based arrangements. Issue resolution and escalation management Timely, clinically grounded support for complex provider concerns and relationship risks. Special projects contribution Meaningful contributions to NPR special projects, tools, resources, best practices, and operational consistency. Cross-functional leadership Strong partnership across network, contracting, clinical, analytics, market, and finance teams. Qualifications Required MD or DO degree. Active, unrestricted medical license. Board certification in an ABMS-recognized specialty. Minimum 5 years of clinical practice experience. Minimum 3 years of healthcare leadership, payer, network, provider relations, or value-based care experience. Demonstrated ability to influence physician leaders, provider executives, and cross-functional partners. Strong understanding of healthcare economics, clinical quality, utilization, population health, and performance improvement. Exceptional communication, presentation, relationship-building, and executive presence skills. Ability to operate effectively in a highl