[Hiring] Chief Medical Officer @The Cigna Group

Role Description

The Chief Medical Officer (CMO) for Evernorth will serve as the senior physician leader responsible for advancing and supporting clinical strategy across Evernorth’s diverse businesses, in collaboration with the business leaders. This includes Express Scripts and Evernorth Health Services pharmacy and care delivery businesses. This role is designed for an innovative physician executive with deep expertise in pharmacy, PBMs, specialty drugs, disease management, technology and AI, external and government affairs.

Reporting to the Chief Medical Officer of The Cigna Group and partnering closely with Evernorth senior P+L and clinical product and operations leaders, the CMO will collaborate with key leaders to shape Evernorth’s clinical vision, drive strategic initiatives to enhance quality, affordability and innovation and advance the organization’s clinical value proposition.

The CMO will also serve as an external-facing clinical leader, representing Evernorth to clients (employers and health plans), providers, key external partners and regulators. This role will also entail bringing market, client, provider, pharma, government and industry perspectives into Evernorth’s business priorities, product innovation, and growth agenda.

This role also provides oversight of key areas of clinical operations, including Pharmacy Prior Authorization (PA) operations. This will include both maintaining the highest level of operations, clinical integrity and patient experience, as well as advancing Enterprise PA transformation efforts, ensuring PA priorities are integrated with The Cigna Group’s clinical strategy.

Qualifications

• Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) required.
• MBA and/or relevant management consulting experience preferred.
• 15+ years of clinical and clinical leadership experience, ideally with background in specialty pharmacy, pharmacy benefits management, pharmacy managed care, pharmacy retail or industry setting.
• Experience, training and expertise to provide clinical leadership and inform strategy across a broad range of therapeutic categories, clinical programs, products and emerging pharmacy trend areas.
• Demonstrated experience leading and scaling complex clinical operations across multi-site, regional, or national healthcare organizations.
• Demonstrated initiative with proven ability to influence business strategies in support of major organizational and market initiatives, work cross-functionally with various departments and set priorities.
• Demonstrated ability to think strategically, anticipate future consequences and trends, and incorporate them into short-term and long-term organizational plans.
• Inspirational, compelling leader capable of communicating a vision to external and internal constituents and commanding respect and enthusiasm.
• Ability to build strong relationships with executive members of client organizations, external partners and senior internal stakeholders.
• Enterprise thinker with proven ability to influence across a matrix environment and build strong relationships across all levels of the organization.
• Demonstrated ability to simplify clinical program complexity into clear, measurable value.
• Strong persuasion skills and effective communicator; able to create and communicate a compelling vision internally and externally.
• Able to act and react as necessary, even when limited information is available; comfortable taking charge of complex situations, overcoming resistance and taking necessary stands when appropriate.
• Strategic and client-focused mindset with the ability to balance clinical excellence, business objectives, patient outcomes and market opportunities while effectively influencing stakeholders across a complex matrix organization.

Requirements

• Partner with senior Evernorth business leadership to collaborate in evolving Evernorth’s clinical narrative and strategic direction.
• Drive the advancement of strategic clinical work across relevant Evernorth businesses.
• Serve as liaison to bring external client, market, provider and clinical perspectives to internal product, business and enterprise partners.
• Connect the clinical community across relevant Evernorth businesses and functions.
• Build and strengthen strategic account relationships with Sales, Product, Account Management, client strategy and business leaders.
• Provide strategic clinical and operational input into proposals, finalist presentations and operational execution processes.
• Collaborate with key stakeholders to advance provider relationships and integrated care models.
• Establish and maintain executive-level strategic relationships with senior clinical, pharmacy, provider, client and business leaders.
• Collaborate with Evernorth business leadership to drive Evernorth’s clinical engagement in government-related initiatives.
• Partner with internal teams to monitor clinical and operational performance in pharmacy UM.
• Guide design and delivery of innovative Evernorth pharmacy-related clinical solutions.
• Serve as a critical partner to Evernorth leadership with matrix accountability to Evernorth business leaders.

Benefits

• Comprehensive range of health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
• 401(k) and company paid life insurance.
• Tuition reimbursement.
• A minimum of 18 days of paid time off per year.
• Paid holidays and leaves of absence.