The Cigna Group
Medical Senior Director, Care Delivery Model and Payment Innovation
The Medical Senior Director, Care Delivery Model and Payment Innovation, leads the redesign and scaling of enterprise population health programs and risk-based care strategies. This role drives innovation in care delivery models and alternative payment models, partnering across clinical, network, and analytic teams to improve quality, affordability, and outcomes.
Key Responsibilities
- • Lead the re‑design and modernization of existing risk‑based and alternative payment programs, ensuring alignment with evolving market, provider, and regulatory dynamics.
- • Identify, structure, and clinically guide external partnerships (e.g., provider organizations, enablement platforms, care delivery partners) that accelerate growth in two‑sided risk participation across primary and specialty care.
- • Shape and operationalize enterprise risk-based payment and care delivery strategy across markets and products.
- • Partner with Network, Contracting, and Actuarial teams to expand the portfolio of value‑based offerings beyond total medical cost to true total cost of care management, including pharmacy and other clinical services.
- • Support differentiated risk‑aligned care and payment offerings and support models.
- • Serve as a senior clinical voice in evaluating new market opportunities and partnership models that drive sustainable scale in risk‑bearing and outcomes‑aligned models.
- • Drive innovation in care delivery through the design, evaluation, and scaling of advanced primary care and specialty care models, including multidisciplinary and team‑based approaches.
- • Support development of care models that integrate physicians, pharmacists, behavioral health clinicians, and other members of the clinical care team to improve outcomes and total cost of care.
- • Expand alternative payment models to other lines of business, including international health.
- • Translate clinical and utilization insights into targeted interventions.
- • Lead pilots and test‑and‑learn initiatives that incorporate new care delivery partnerships, digital enablement, and alternative network strategies, with rigorous clinical and financial evaluation.
- • Ensure care models align with evidence, regulation, provider workflows, and member experience.
- • Maintain a close, ongoing partnership with the PNR team as the primary market‑facing execution arm for care delivery model and payment innovation as well as provider engagement.
- • Provide clinical leadership for Network strategies, influencing design, contracting approaches, and performance expectations.
- • Help reimagine the provider relationship, expanding the definition of “provider” beyond physicians to include pharmacists and other clinical care team members within contracting and performance models.
- • Guide provider- and market-level insight development on cost, quality, utilization, and risk.
- • Represent the organization in strategic discussions with senior provider and system leadership regarding network participation, care delivery transformation, and risk‑based collaboration.
- • Build and mentor multidisciplinary teams.
- • Drive execution through influence in a matrixed enterprise environment.
Required
- • MD or DO with board certification.
- • 10+ years of progressive clinical leadership experience.
- • Deep experience in alternative payment models, population health, and clinical analytics.
- • Proven ability to lead complex initiatives across matrixed organizations.
Preferred
- • Advanced degree (MPH, MHA, MBA, or equivalent).
- • Experience with large-scale care model design and performance evaluation.
- • Background in payer, provider, or risk-bearing organizations.
Benefits & Perks
- • Medical, vision, dental, and well-being and behavioral health programs starting on day one.
- • 401(k).
- • Company paid life insurance.
- • Tuition reimbursement.
- • A minimum of 18 days of paid time off per year.
- • Paid holidays.
Company Overview
Industry: Healthcare Technology
Company Size: 500-1,000 employees
Founded: 2015
Headquarters: San Francisco, CA
Company Links
Key Contacts
Contact information not available
About the Company
Leading healthcare technology company focused on improving patient outcomes through innovative digital solutions. We're transforming the way healthcare is delivered with cutting-edge technology and data-driven insights. Our platform serves over 10,000 healthcare professionals and has processed millions of patient interactions.
Recent News & Updates
Series B
Raised $50M Series B funding - Jan 2024
Award
Named "Best Healthcare Startup" by TechCrunch - Dec 2023
Growth
Expanded to 5 new states - Nov 2023
Position Summary
The Medical Senior Director, Care Delivery Model and Payment Innovation, is a senior physician leadership role responsible for reimagining and scaling enterprise population health programs and risk-based care strategies, while also leading strategic external partnerships that accelerate participation of providers and patients in advanced alternative payment models within primary and specialty care. This role reports to the Associate Chief Medical Officer for Value-Based Care, Trend, and Provider and Network Relations.
This position advances the organization’s evolution from traditional total medical cost programs to total cost of care management across the enterprise—working towards integration of medical, pharmacy, behavioral, and other clinical domains into cohesive total cost-of-care and outcomes-driven strategies. The leader serves as a clinical integrator across Affordability, Product, Provider Relations, Network, Network Strategy, and Data & Analytics—ensuring that care models, incentives, and performance management approaches are clinically sound, analytically rigorous, and operationally scalable. The role will lead strategic test-and-learn initiatives that inform innovation in population health and total cost of care management.
The role partners closely with Provider & Network Relations (PNR) as the market‑facing execution arm, aligning strategy with local provider engagement, contracting, and implementation to drive measurable improvements in quality, affordability, and experience across populations.
Key Responsibilities
Enterprise Alternative Payment Model Strategy, Partnerships, & Growth
Required
For this position, we anticipate offering an annual salary of 262,400 - 437,400 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus and long term incentive plan.
At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here.
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: [email protected] for support. Do not email [email protected] 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.
The Medical Senior Director, Care Delivery Model and Payment Innovation, is a senior physician leadership role responsible for reimagining and scaling enterprise population health programs and risk-based care strategies, while also leading strategic external partnerships that accelerate participation of providers and patients in advanced alternative payment models within primary and specialty care. This role reports to the Associate Chief Medical Officer for Value-Based Care, Trend, and Provider and Network Relations.
This position advances the organization’s evolution from traditional total medical cost programs to total cost of care management across the enterprise—working towards integration of medical, pharmacy, behavioral, and other clinical domains into cohesive total cost-of-care and outcomes-driven strategies. The leader serves as a clinical integrator across Affordability, Product, Provider Relations, Network, Network Strategy, and Data & Analytics—ensuring that care models, incentives, and performance management approaches are clinically sound, analytically rigorous, and operationally scalable. The role will lead strategic test-and-learn initiatives that inform innovation in population health and total cost of care management.
The role partners closely with Provider & Network Relations (PNR) as the market‑facing execution arm, aligning strategy with local provider engagement, contracting, and implementation to drive measurable improvements in quality, affordability, and experience across populations.
Key Responsibilities
Enterprise Alternative Payment Model Strategy, Partnerships, & Growth
- Lead the re‑design and modernization of existing risk‑based and alternative payment programs, ensuring alignment with evolving market, provider, and regulatory dynamics.
- Identify, structure, and clinically guide external partnerships (e.g., provider organizations, enablement platforms, care delivery partners) that accelerate growth in two‑sided risk participation across primary and specialty care.
- Shape and operationalize enterprise risk-based payment and care delivery strategy across markets and products.
- Partner with Network, Contracting, and Actuarial teams to expand the portfolio of value‑based offerings beyond total medical cost to true total cost of care management, including pharmacy and other clinical services.
- Support differentiated risk‑aligned care and payment offerings and support models.
- Serve as a senior clinical voice in evaluating new market opportunities and partnership models that drive sustainable scale in risk‑bearing and outcomes‑aligned models.
- Drive innovation in care delivery through the design, evaluation, and scaling of advanced primary care and specialty care models, including multidisciplinary and team‑based approaches.
- Support development of care models that integrate physicians, pharmacists, behavioral health clinicians, and other members of the clinical care team to improve outcomes and total cost of care.
- Expand alternative payment models to other lines of business, including international health.
- Translate clinical and utilization insights into targeted interventions.
- Lead pilots and test‑and‑learn initiatives that incorporate new care delivery partnerships, digital enablement, and alternative network strategies, with rigorous clinical and financial evaluation.
- Ensure care models align with evidence, regulation, provider workflows, and member experience.
- Maintain a close, ongoing partnership with the PNR team as the primary market‑facing execution arm for care delivery model and payment innovation as well as provider engagement.
- Provide clinical leadership for Network strategies, influencing design, contracting approaches, and performance expectations.
- Help reimagine the provider relationship, expanding the definition of “provider” beyond physicians to include pharmacists and other clinical care team members within contracting and performance models.
- Guide provider- and market-level insight development on cost, quality, utilization, and risk.
- Represent the organization in strategic discussions with senior provider and system leadership regarding network participation, care delivery transformation, and risk‑based collaboration.
- Build and mentor multidisciplinary teams.
- Drive execution through influence in a matrixed enterprise environment.
Required
- MD or DO with board certification.
- 10+ years of progressive clinical leadership experience.
- Deep experience in alternative payment models, population health, and clinical analytics.
- Proven ability to lead complex initiatives across matrixed organizations.
- Advanced degree (MPH, MHA, MBA, or equivalent).
- Experience with large-scale care model design and performance evaluation.
- Background in payer, provider, or risk-bearing organizations.
- Demonstrated ability to build and scale value‑based care ecosystems, including external partnerships, advanced care models, and provider enablement capabilities
- Clinically credible and analytically fluent.
- Strategic yet execution-oriented.
- Collaborative, pragmatic, and outcomes-driven.
- Passionate about transforming care through delivery and payment innovation
For this position, we anticipate offering an annual salary of 262,400 - 437,400 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus and long term incentive plan.
At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here.
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: [email protected] for support. Do not email [email protected] 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.
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