Chief Quality & Health Advocacy Officer (Finance)

Flexible Onsite Location: Bloomfield, CT, St, Louis, MO, Philadelphia, PA, other locations where The Cigna Group has an office presence.

Organization: Office of the Chief Health Officer (OCHO) Organization

Position Summary:The Chief Clinical Experience and Quality Officer (CEQ) at The Cigna Group is responsible for overseeing the quality of healthcare services and clinical aspect of patient experience and engagement. This role will lead a cross-functional team of clinical and business leaders in OCHO and business units to build solutions, processes and functions that ensure a high degree of clinical integrity and quality and an outstanding clinical journey and experience for our patients. The CEQ Officer will work closely with clinical, administrative, and technology teams to drive quality improvement initiatives, leverage data analytics, and enhance patient outcomes and satisfaction.

Key Responsibilities:

• Quality Management:
  
  • Develop and implement quality improvement and outcome strategies aligned with organizational goals.
  • Collaborate with stakeholders to set and monitor key performance indicators (KPIs) related to healthcare quality and outcomes.
  • Oversee quality assurance programs to ensure compliance with local, state, and federal regulation and with healthcare quality standards, including HIPAA, JCAHO, and CMS as well as HEDIS, NCQA Health Plan Ratings, STARS, and CAHPS compliance.
  • Identify and mitigate risks related to healthcare quality and implement continuous improvement methodologies like Six Sigma or Lean Healthcare.

• Patient Experience:
  
  • Implement and oversee a comprehensive patient experience strategy and develop strategies to enhance patient communications and experience and promote a patient-centric culture that improve overall patient satisfaction and loyalty.
  • Oversees the collection, analysis, and reporting of patient experience data across the business silos to create a holistic view of patient experience, quality and outcomes including trends, risks, and opportunities related to consumer experience.
  • Utilize journey mapping to improve consumer experience in benefits, claims, prior authorizations, and other services across multiple channels (email, social media, phone digital, letters, etc.) to optimize client and customer loyalty, experience, and retention.
  • Monitor and report on key performance indicators (KPIs) related to consumer satisfaction and experience.
  • Stay current with industry trends and best practices in consumer economics and incorporate relevant innovations into the strategy.
  • Collect and analyze patient feedback to identify areas for improvement.
  • Educate staff on the importance of patient experience and promote a patient-centered culture and communicate patient experience goals and outcomes to stakeholders.
  • Leverage technology to enhance patient experience, including digital feedback tools and data analytics.

• Leadership & Team Management:
  
  • Collaborate with stakeholders to develop business cases and monitor performance.
  • Lead and develop a multidisciplinary team focused on clinical excellence, quality and patient experience.
  • Foster a culture of continuous improvement and innovation.
  • Represent the department in executive meetings and external forums.

• Stakeholder Engagement & Collaboration:
  
  • Collaborate with internal entities, healthcare providers, and members/patients to improve quality and integration of interventions.
  • Engage with industry experts and participate in relevant forums and committees.

Required Qualifications:

• MD or DO with board certification.
• 15+ years of leadership experience in a large healthcare organization, including 5+ years in direct leadership of patient experience and quality improvement.
• Strong knowledge of healthcare quality standards and patient experience strategies.
• Excellent leadership skills, strategic thinking, and ability to execute for results in a complex commercial environment.
• Proven ability to innovate and drive organizational change.
• Experience in a highly matrixed organization with strong internal enterprise relations.
• Strong communication skills, with the ability to translate complex topics into consumable formats.

Key Competencies:

• Strategic Mindset
• Builds Networks
• Manages Conflict
• Organizational Savvy
• Courage
• Drives Vision and Purpose
• Persuades
• Cultivates Innovation
• Situational Adaptability
• Ensures Accountability
• Resourcefulness

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 The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com 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.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.