Data Management Strategy & Governance Senior Manager (Clinical Quality) - Evernorth Health Services - Remote

Job Overview:

This role is responsible for driving the Clinical Quality data acquisition strategy and data product support within the Enterprise Quality & Accreditation organization.  The data being acquired will be used to measure clinical quality results that ultimately allow Cigna to benchmark against competitors, and drive improvements in patient outcomes.  This data will feed into HEDIS and NCQA accreditations.  This position will be responsible for driving the multi-year roadmap of data work and will directly enable the transition towards digital quality measures (dQM) as mandated by regulatory needs.  This position leads a team inclusive and not limited to a Clinical Data Governance Lead and a Clinical Data Steward.  Responsibilities include overseeing the Clinical Quality data infrastructure, data quality, data acquisition, data expansion, pursuing the highest value use cases, and implementing in an organized, timely, and effective manner.  As dQM depends on timely, standardized, and complete clinical data, this role is essential to translate strategic quality goals into actionable partnerships with external provider organizations. It ensures the business has the right contractual, operational, and relationship frameworks to support digital data acquisition at scale—particularly in Value Based Program (VBP) aligned environments. 

Key Functions:

Data Strategy & Delivery

• Develop multi-year data roadmap that allows Cigna to meet digital quality measurement (dQM) regulatory objectives
• Drive the delivery of the clinical quality data strategy, ensuring that development is occurring on time and within budget
• Secure funding to achieve the priority outcomes needed corresponding with the roadmap timeline
• Prioritize data acquisition and vendor strategy based on cost/benefit analysis and provide recommendations on vendor/tool usage to close data gaps
• Partner with architecture and engineering teams to ensure data platforms and infrastructure support business priorities and long-term strategy
• Advocate for scalable, flexible solutions that enable future growth and innovation
• Translate business objectives into strategic data capabilities, enabling the matrixed cross functional team to prioritize investments that directly support digital transformation

Data Product Ownership

• Function as the business product owner for the Clinical Quality data product
• Coordinate with technical data product delivery teams to build enterprise data product that will house clinical quality data
• Drive the adoption and transition of reporting and analysis to pull from new data product

Contractual Data Enablement

• Evaluate existing vendor and provider agreements to assess if they support digital clinical data capture.
• Provide recommendations for which vendors are strategic, and which vendors can be sunset because of building direct connections to source data
• Partner with the contracting team to embed SLAs, FHIR/API expectations, and documentation standards.

Data Quality Liaison

• Coordinate with analytics and validation teams to share discrepancies with providers (e.g., missing codes, delayed data, incomplete payloads).
• Establish a feedback loop with providers to close data gaps and improve compliance.
• Ensure development of data products and data feeds are well governed, have data stewardship, and meet compliance standards.

Support for Value-Based Care (VBP)

• Align provider-facing data expectations with VBP quality metrics and scorecards.
• Ensure providers understand which clinical actions and documentation impact quality scores and financial incentives.

Leadership /Mentorship

• Manage team consisting of data governance and data stewardship roles
• Provide development opportunities and drive upskilling plan
• Network and build connections with partner teams such as Data Engineering, Interoperability, Clinical Initiatives, and HEDIS Operations

Qualifications:

• Master’s degree preferred, or Bachelor’s degree with 10+ years’ experience in data project delivery
• 7+ years professional work experience in:
  • Driving the data strategy and data product development at a Fortune 50 or larger size company
  • Driving multi-million dollar investments and navigating enterprise portfolio funding process
  • Data Governance, Data Management, Data Quality, or Process Improvement practices
  • Healthcare payer data products and processes
  • Clinical data standards and operations
  • Clinical terminology, concepts, business processes and data management lifecycle related to Health Services, Care Management, and Health / Wellness programs (e.g., utiliz