Clinical Operations Director - Remote

2d2 days ago

The Cigna Group

US · Full-time · $144,200 – $240,400

About this role

This role provides leadership across Premium Solutions clinical operations, product integration, and business performance. The position is responsible for operational execution, clinical outcomes, alignment to product strategy, and financial performance for high-value client segments.

Working closely with the Managing Director of Case Management Operations and senior cross-functional partners, this role connects strategy with execution to support the design, implementation, and ongoing improvement of differentiated service models that drive client retention, growth, and operational scalability.

This position supports a large and complex population across high-value client relationships and operates with broad cross-functional influence. Responsibilities include balancing client experience, operational scalability, financial stewardship, and clinical performance in a dynamic healthcare environment.

The position requires strong strategic judgment, executive presence, and the ability to influence across matrixed teams while maintaining focus on operational execution. This role may require presence in an office if your location is within reasonable proximity to a Cigna office.

Requirements

Active Unencumbered Registered Nurse (RN) license required.
Minimum of 10 years of experience in healthcare operations, case management, or clinical program leadership.
Demonstrated leadership experience in complex, matrixed healthcare organizations.
Experience leading large operational teams with multiple levels of leadership.
Strong knowledge of clinical operations, care management, and performance management.
Proven ability to influence and collaborate across Product, Sales, Clinical, and Operations teams.
Experience supporting strategic initiatives, operational transformation, or service model implementation.
Strong communication, presentation, and executive stakeholder management skills.

Responsibilities

Lead clinical operations and case management programs across Premium Solutions client segments.
Drive performance across quality, engagement, operational efficiency, and client experience metrics.
Support the implementation and optimization of enhanced client service models, including designated and dedicated team structures.
Oversee audit readiness, accreditation activities, and quality governance programs.
Partner across Product, Clinical, Operations, Sales, and Account Management to align strategy with service delivery.
Monitor performance guarantees and support measurement and achievement activities.
Lead and develop leaders across clinical and operational functions.
Represent Clinical Operations in enterprise initiatives, strategic discussions, and client-facing activities, including RFPs and finalist presentations.