Network Operations Director - Hybrid

at The Cigna Group in Chicago, Illinois, United States

Job Description

This is a hybrid role and will require the ability to work in person.

Excited to grow your career?

We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success.

Position Overview:

+ The selected candidate will be an integral member and key leader of our Provider Solutions and Operations (PS&O) team at Evernorth. The role will report to the Senior Director of Network Operations in support of Provider Network Operations including Provider Data Management and Network Specialty teams (Network Reimbursement, Third Party Vendor Management and the Provider Tax Integrity Team) which are critical operations in support of growth and expansion.

+ Responsibilities will include: leading a large, multifunctional team (domestic and global service partners) within the operations; development and support of operational priorities and goals; connector within PS&O and other business units to ensure business challenges are prioritized, addressed and escalated appropriately; provide strategic guidance on operational imperatives; provide thought leadership to leadership and teams as it relates to translating future state vision into short, mid, and long term team efforts; translating legacy business operations & process to future state; creating and delivering scale via shared services lens; driving operational discipline via governance & quality programs; managing, influencing & building key matrix partner relationships; developing business cases and/or supporting materials and insights in support of funding needs for operational improvements.

+ As a senior leader within the operations, the role will require working closely with various partner organizations including multiple teams within PS&O, Delivery & Solutions, Market Leads, contracting teams, Operations Strategy & Enablement (quality, readiness, change management, eMOS, PMO, etc.), Workforce Management / Capacity Planning, various P&L partners, Finance, Technology, and external vendor partnerships.

RESPONSIBILITIES:

+ Managing and leading changes within the operations by understanding impacts of large scale initiatives being driven by enterprise (e.g. portfolio, automation, cost to serve, shared services, etc.).

+ Identifying & influencing partners on operational efficiency and improved quality opportunities across people, process, and technology.

+ Monitor and evaluate performance metrics through data analytics to ensure high-quality outcomes and service delivery. Ensure operational compliance with relevant regulatory standards, including HIPAA and CMS, to maintain compliance and mitigate risks.

+ Ensuring operational data integrity by collaborating with organizational stakeholders with integrating new technologies and systems that enhance operational provider data management capabilities and improvement to accuracy and efficiency.

+ Drive continuous improvement initiatives to streamline provider data management processes, utilizing methodologies such as Lean, Six Sigma, or Agile to eliminate inefficiencies and enhance operational performance.

+ Translating performance against KPI’s into operational requirements for improvement (e.g. capacity, financial, automation, etc.)

+ Operationalize best practices in a shared services organization by driving consistent standards, governance and process adoption, leveraging consistent tools and establishing common ways of working .

+ Establishment of strong working relationships and develop a high level of credibility across the business, including other senior leaders, matrix partners, vendor partners.

+ Facilitate and coordinate identification and fulfilment of key deliverables / objectives to drive incremental progress towards Objectives & Key Results, program initiatives, departmental & enterprise goals.

+ Act as a connection point among business leadership & key program delivery leads by providing proactive identification of opportunities and issues that could impact the successful execution of commitments & offer viable alternative solutions.

+ Proactively ideates, identifies, develops, and drives key strategic initiatives that deliver short/long term operational efficiencies and expense improvements.

+ Assessing, developing and implementing management best practices (strategies, tools, scorecards) for the evolving operations.

+ Serving as key representative to designated internal / external stakeholders.

+ Initiating and maintaining effective channels of communication with matrix partners on operational performance, escalating and communicating impacts and associated remediation.

+ Inspires a collaborative culture, provides coaching, guidance, and career development support to team.

Level of Leadership:

+ Self-directed and capable of leading a team of operatational professionals and subject matter experts, either as a direct manager or as a cross organizational team leaders.

+ Maintains a positive working relationship with teammates and matrix partners.

+ Continually strives to improve their own skills and competencies by demonstrating initiative to participate in ongoing coaching and training programs.

+ Demonstrated ability to drive results required.

+ Able to influence in direct and matrix environment.

+ Be a positive role model.

KNOWLEDGE/COMPETENCIES:

+ Bachelor’s Degree or higher strongly preferred or equivalent work experience required.

+ 5+ years’ experience in Healthcare Operations, Network Operations, and/or Provider Operations.

+ 8+ years’ experience managing operations and/or large scale programs / projects.

+ Strong business acumen, with proven ability to leverage knowledge base to quickly come up to speed in new business areas and new types of projects.

+ Proven results of building and creating new structures through the use of creativity and innovation management.

+ Experience, ability and willingness to share knowledge and coach individuals with varying levels of experience.

+ Detail oriented, with proven time management and organization skills (including the ability to engage in multiple tasks and meet deadlines/standards).

+ Ability to deal with ambiguity, embracing change and helping others see it as an opportunity and stay focused on goals while adapting to change.

+ Comfortable with raising questions, issues, ideas or suggestions to co-workers at all levels across all organizations.

+ Excellent communication skills – verbal and written and training, along with excellent presentation skills.

+ Ability to work in a matrix environment.

+ Works well with larger groups from a wider range of organizations, as well as reporting out to senior executives.

+ Travel may be required (+25%), including International.

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.

For this position, we anticipate offering an annual salary of 139,000 – 231,600 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.

We want you to be healthy, balanced, and feel secure. That’s why 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) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per