Interoperability Program Lead Senior Advisor- Remote- Cigna Healthcare

Job Summary:

This position is responsible for leading and evolving the optimization of the Stars and Risk Adjustment (SRA) Enablement Interoperability strategic initiatives.  This individual will be responsible for developing a roadmap of interoperability use cases and executing on that roadmap, with the goal of improving payer and provider data exchange to better inform patient care, improved clinical documentation, and strengthen customer experience. 

Core Responsibilities:

• Design and develop the interoperability roadmap and initiatives in collaboration with matrix partners with a focus on Medicare Advantage Stars and Risk Adjustment lenses. 
• Develop and execute of interoperability capabilities with goals of enhancing chart retrieval, data ingestion for analysis, and leveraging information sent to providers. 
• Influence the technology roadmap around interoperability; represent business leadership in making key architectural decisions for payer and provider data exchange. 
• Collaborate with matrix leadership across the organization to successfully align enterprise initiatives with local nuances with ability to provide alternate optionality
• Serve as a conduit to leadership and local markets of current initiatives with progressing toward longer term vision as subject matter expert in Enablement programs
• Build and analyze current state processes across matrix partnerships to allow for clear direction and identification of best practices and areas of growth
• Serve as the business expert on interoperability regulation and inform key compliance efforts
• Design the specific execution of use-cases across the organization (e.g. risk adjustment coding, analytical model augmentation, payer-to-provider data sharing, etc.)
• Develop governance processes to ensure efficient prioritization of investments
• Champion Medicare business needs and requirements within enterprise interoperability efforts

• Coordination with Provider Performance Enablement leadership on provider group prioritization and engagement in oversight of clinical data integration strategy, governance and execution.
• Create business cases with credible ROI projections to persuade key decision-makers
• Maintain vendor relationships with accountability to their goals per contractual relationships

Minimum Qualifications:

• Bachelor’s degree preferre, or 6 years minimum Clinical Data Exchange and/or Interoperability experience
• Master’s degree preferred
• Technical acumen around interoperability and bi-directional data exchange
• Strong knowledge of the regulatory environment and CMS requirements for Interoperability
• Proven ability to collaborate with matrix partners to accomplish goals
• Strong ability to evaluate, interpret and manipulate data
• Project management and organizational excellence experience
• Excellent verbal and written communication skills; ability to prepare and deliver presentations to managers and clinicians
• Strong ability to prioritize near term projects with direction improvement to long term solutions
• Ability to persuade high-level executives toward a plan of action using data-driven analyses
• Strong knowledge of  Medicare Advantage Stars and Risk Adjustment business needs
• Experience with electronic health record (EHR) platforms and capabilities

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 110,000 - 183,300 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 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 year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.

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: 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.

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