Medical Director - Clinical Strategy

Medical Director Clinical Strategy

Role Summary
The Clinical Strategy Leader, will report to the Associate Chief Medical Officer for Clinical Product and Solution Design and support the development and execution of Cigna Healthcare’s strategy for members with high-risk and complex care needs. This includes high-risk members with complex chronic conditions, oncology needs, high drug spend, serious illness, specialty pharmacy needs, and other populations requiring advanced clinical navigation and case management support.
This leader will help translate clinical, business, and affordability priorities into actionable strategies, scalable clinical programs, digital and AI-enabled solutions, and measurable execution plans. The role will partner across Clinical, Product, Strategy, Technology, Data, Operations, Pharmacy, Finance, and market-facing teams to identify priority opportunities, design differentiated solutions, develop business cases, support implementation, and measure impact.
A core focus of the role will be leading the development of digital and AI-enabled solutions for high-risk members, including AI agents, advanced segmentation, proactive member engagement tools, digital navigation capabilities, clinical workflow support, and technology-enabled case management models.
This role will be critical to positioning Cigna Healthcare as a market-leading clinical organization by translating complex care needs into differentiated scalable solutions that improve outcomes, affordability, and member experience.
The ideal candidate will be a strategic, execution-oriented health care leader who can combine clinical insight, business acumen, analytics, digital fluency, and strong cross-functional leadership to improve health outcomes, member experience, affordability, and enterprise value.
Responsibilities

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Support development and execution of Cigna Healthcare’s strategy for high-risk and members with complex care needs, including oncology, high drug spend, serious illness, specialty pharmacy needs, and complex chronic conditions.

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Translate clinical and business priorities into strategic roadmaps, business cases, implementation plans, and measurable performance goals.

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Lead the design of scalable clinical programs for high-risk and complex populations, including identification, engagement, navigation, escalation, care coordination, and longitudinal support.

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Lead development of digital and AI-enabled solutions for high-risk members, including AI agents, advanced segmentation, proactive outreach, member-facing navigation, clinician workflow support, and next-generation case management capabilities.

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Partner with Product, Technology, Data, Clinical Operations, Pharmacy, Analytics, Finance, and market-facing teams to identify priority use cases, define requirements, and support execution through implementation.

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Use data, analytics, claims insights, clinical and pharmacy trends, operational performance, and client needs to identify opportunities and prioritize initiatives.

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Improve case management and complex care models, including structured case review processes, high-risk case management, and targeted interventions for priority populations.

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Develop performance measurement frameworks, including KPIs related to clinical outcomes, affordability, member experience, engagement, operational efficiency, clinician adoption, and client value.

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Drive process improvement and operating model enhancements to improve scalability, consistency, and execution discipline.

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Align stakeholders across a matrixed organization to establish shared priorities and drive improved business outcomes.

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Prepare executive-ready strategy documents, updates, recommendations, and decision materials for senior leadership.

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Lead cross-functional teams and workgroups through complex initiatives, fostering accountability and collaboration.

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Bring an outside-in perspective on clinical innovation, digital health, AI-enabled care