ABOUT US: Cigna healthcare is a global health service company with roots in the US, serving more than 180 million customers and patients throughout the world. We deliver quality health care through choice, predictability, affordability and through integrated capabilities and connected, personalized solutions that advance whole person health. Cigna's mission is to help our customers improve their health, well-being and sense of security by providing access to care. With our whole health approach, we're focused on addressing health concerns, improving resilience, reducing stress levels and emotional health issues. Our employer promise is to remain steadfast in our commitment to fostering growth and improving lives by offering meaningful work within a positive, inclusive culture that prioritizes our colleagues. We champion teamwork and collaboration and empower our people with cutting-edge technology to drive efficiency and amplify their impact in everything we do. Together we strive to create an environment where every individual thrives and contributes to meaningful change" POSITION SUMMARY The Provider Segmentation & Directional Care Manager (PSDCM) will be responsible to program manage the Cigna Healthcare International Provider Segmentation Program. The PSDCM will work with the Head of Global Network Strategy to revamp and expand upon Cigna's existing Cigna Select and Cigna Specialty Providers program that focus on general tertiary-quaternary hospital (Cigna Select) and service line specific capabilities such as musculoskeletal and physiotherapy, cardiac, oncology, and neurology (Cigna Specialty Providers) to support customers having access to high-quality, affordable healthcare options. The PSDCM will lead the quality benchmark components to assess and monitor provider quality both in line with publicly reported benchmarks (such as through country or region-specific reporting registries and in alignment with the International Consortium for Health Outcomes Measurement (ICHOM), understand clinical or specialist capability, and consolidate a view on relative cost (and in the future, value) position for providers which are part of the program. This position supports the affordability component led by the Network Team. It further supports the delivery of Cigna's strategic priorities (such as City Strategies) predicated on provider segmentation. The program is unique amongst international competitors and looks to support improved customer experience and improved relationships with providers by focusing on quality assessment against recognized standards of care and a deeper understanding of clinical performance and specialist capabilities. Operationally the program also supports sales and retention strategies and new product development with the development of specialty networks through forms of value-based remuneration. The PSDCM will have day-to-day operational responsibility for managing a program of clinical review and assessment as well as partnering with Clinical teams for the ongoing monitoring of clinical data submitted by participating providers. The PSDCM will act as the principle point of contact for queries related to the outputs of clinical assessment and provide project management support to local Clinical and Network teams to deliver on their strategic objectives. Reports to: Head of Global Network Strategy DUTIES AND RESPONSIBILITIES Provider Segmentation Strategy - Reviews and redesigns (with a mindset driven to simplification, standardization, and scalability) of the assessment and reporting processes required by providers - Defines differences in requirements between hospital-wide (currently Cigna Select), specialty-level (currently Cigna Specialty Providers), and center of excellence segmentation offerings - Inventorying, categorizing, and reporting national and international reporting bodies and Key Performance Indicators - Aligning Cigna Healthcare International's safety, outcomes, and efficiency metrics to national and international reporting benchmarks - Supporting Head of Global Network Strategy with driving alignment across other major insurers and key providers around metrics measured and data definitions - Leading internal staff training, awareness, and Standard Operating Procedure development across Clinical, Network, Provider Services Organization (PSO), and Commercial teams to raise visibility and enhancements to Cigna Healthcare International Provider Segmentation program - Develop hospital comparison scorecard to assessindividual providers against average of peers internationally and by region (where possible), with reference to refined and aligned metrics Provider Segmentation Operations - Operational day-to-day management of the Cigna Healthcare International Provider Segmentation program - Apply established program management principles to manage the program to a high standard and ensure monitoring of performance and delivery of objectives - Manage the entire process from engagement and support throughout the (re-)assessment processes - Define and manage, using Data & analytics (D&A) resources, a central database for collected quality, outcomes, and efficiency data - Manage requests and assess suitability from hospitals to participate in specialty assessment and clinical outcomes programs - Provide summary analysis and feedback to providers on the outputs of assessments, in conjunction with the Clinical Leads - Engage and then routinely monitor key providers through the clinical data scorecard - Establishing, supporting, and maintaining relationships with key providers including management and development of marketing and communication materials - Completing a schedule of specialty assessments to support the delivery of the provider segmentation program Directional Care - Produce detailed internal program and project plans for activities related to the program of work or new priorities aligned with markets with high spend or fragmented with expansive provider networks - In conjunction with Head of Global Network Strategy, develop mechanisms to leverage value with quality, outcomes, and efficiency metrics to improve commercial negotiations with providers - Provide feedback to and support development of value-based remuneration contracting methods - Partner with the various books of business and shared teams (e.g., D&A and IT) to enhance guidance through member portal and provider information for segmented providers - Support the development of a series of outputs from the quality program to support customer decision-making, sales opportunities, and product development within concentrated cities - Support Clinical, Network, and PSO leads with preparation for onsite evaluations and meetings with focus on quality data - Work with Head of Global Network Strategy and Network and Clinical teams to develop specialty-specific guidance network for complex service offerings (e.g., gene therapy and transplants) ROLE REQUIREMENTS - A degree-level education in a subject related to the medical field or equivalent clinical experience (e.g., nursing or allied healthcare), experience working within clinical governance or risk management, or consulting or provider experience with quality data is required - Related post-graduate education (e.g., quality improvement or clinical governance or management) and knowledge of the approaches used in governance, risk management, and quality in healthcare is highly preferred - Formal qualification in project management (e.g., PRINCE2 practitioner) or equivalent experience of running projects is desirable but not required - An understanding of clinical governance, patient safety initiatives, clinical data, international healthcare systems, and hospital assessment processes is desirable - Proven analytical skills, organization, and delivery is required - A capacity to learn quickly and offer innovative thinking to realize solutions is required PERSONAL COMPETENCIES REQUIRED - Critical thinking skills, decisive judgment, and ability to be self-directed - Results-oriented, out-of-the-box, problem solver - Ability to organize and manage complex initiatives - Excellent interpersonal, verbal, written, and presentation communication skills - Mature, with ability to effectively communicate and influence individuals and stakeholders at all levels - Understanding of clinical governance / patient safety and international / cultural perspectives - Ability to evaluate and analyze information from a variety of sources - Strong database management skills - Demonstrable experience of collaborating with remote teams and working in a complex, matrixed organization - Comfortable working in a fast-paced environment with shifting priorities - Energetic and enthusiastic team-player - Ability to speak and write in languages other than English is a value add but not preferred/required - Willing to travel (up to 20%) ENVIRONMENT - The individual needs to demonstrate an ability to modify, adapt, and scale an existing programmatic offering and based on evidenced successes in a short-time frame (one year), expand Provider Segmentation & Directional Care with (an) additional resource(s). - The demanding nature of the role will require the individual to work under pressure and deliver against tight deadlines. - Working hours are predominantly 9am-5pm (depending on the candidate's place of residence) but as the PSDCM will be working with providers in multiple time zones, flexibility is required to ensure that relationships are well managed. Team members within Global Network Strategy and the broader Network and Clinical teams may assist based on each provider engagement. - The PSDCM will be expected to undertake a degree of international travel to visit providers. REGULATORY OBLIGATIONS (to be in all job descriptions) Some roles are included in the Senior Managers and Certification Regime (SM&CR), the basic principle of the Senior Managers Regime is that of responsibility and accountability. A senior manager must take responsibility for the activities under their control to: - Encourage a culture of all colleagues at all levels taking personal responsibility for their actions - Make sure colleagues clearly understand and can demonstrate where responsibility lies - Improve conduct at all levels Regulatory Obligations - Discharge Certification Function and Management Responsibilities in accordance with all applicable regulatory requirements, including the Individual Conduct Rules of the Financial Conduct Authority and, where applicable, the Prudential Regulation Authority. - Ensure areas for which this role has responsibility are adequately monitored and controlled. - Ensure that where responsibilities are delegated, the following safeguards are in place: - People are capable of taking on delegated activities, - People are informed of the extent and limits of delegated responsibilities, ensuring this has been appropriately documented, - Supervise and monitor the people to whom responsibility has been delegated, maintaining a suitable level of understanding of the activity delegated. - Fulfilment of PRA/FCA requirements in respect of the Senior Managers and Certification Regime, including ongoing compliance with fitness and propriety obligations. - Be open and transparent with all relevant governance committees, including the Board, ensuring they are adequately apprised of all significant matters about which they should be made aware. - Accountable for the management of risks inherent in functional area of responsibility and for implementing risk management systems and controls that provide a suitable operational environment to support the delivery of strategic objectives. - To ensure the principle of Treating Customers Fairly and related customer outcomes are embedded within the business and adhered to by the functional area of responsibility. WHAT WE OFFER: - Permanent contract. - Multicultural working environment with Hybrid working. - Enjoy working from the comfort of your home 3 days per week and 2 days from our office. - Social Benefits. - Private Medical Insurance. - Educational Development Program. 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: SeeYourselfEMEAcigna.com for support. Do not email SeeYourselfEMEAcigna.com for an update on your application or to provide your resume as you will not receive a response.