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Principal, Experience & Transformation - Coverage Review - Remote

Key Facts

Remote From: 
Full time
Expert & Leadership (>10 years)
125 - 208K yearly
English

Other Skills

  • Governance
  • Business Acumen
  • Decision Making
  • Accountability
  • Teamwork
  • Verbal Communication Skills
  • Executive Presence
  • Problem Solving

Roles & Responsibilities

  • Bachelor's degree in Business, Healthcare Administration, Operations, or related field; or equivalent combination of education and experience.
  • 10+ years of progressive experience leading operations, experience transformation, strategy, and/or process improvement initiatives in complex organizations.
  • Proven track record of leading large, cross-functional initiatives end-to-end, driving outcomes.
  • Experience operating within healthcare or similarly regulated environments, with strong awareness of compliance, risk, and policy considerations.

Requirements:

  • Lead the design and execution of experience and process transformation initiatives that improve member, patient, and provider outcomes within Coverage Review.
  • Identify experience gaps through KPIs, escalations, complaints, and regulatory requirements, converting insights into clear improvement strategies.
  • Partner cross functionally with Operations, Clinical, Technology, Pharmacy, and Customer Service teams to align experience changes with operational execution.
  • Prepare executive ready insights, materials, and updates related to experience performance, escalation trends, and roadmap progress.

Job description

At The Cigna Group, experience is how trust is built. The Principal, Experience & Transformation role is a senior individual contributor focused on reshaping how member and patient experiences are delivered across Coverage Review. This role leads complex, high-impact initiatives that improve experience outcomes, ensure regulatory compliance, and strengthen business performance connecting strategy to execution through influence, insight, and action.

This position is ideal for a self-starter who naturally sees issues, understands their root causes, and mobilizes cross functional partners to drive meaningful change. Operating without direct people management, the Principal plays a critical role in defining the future state of experience within Coverage Review and translating ideas into scalable, enterprise aligned improvements.

Key Responsibilities

  • Lead the design and execution of experience and process transformation initiatives that improve member, patient, and provider outcomes within Coverage Review.

  • Identify experience gaps through KPIs, escalations, complaints, and regulatory requirements, converting insights into clear improvement strategies.

  • Partner cross functionally with Operations, Clinical, Technology, Pharmacy, and Customer Service teams to align experience changes with operational execution.

  • Prepare executive ready insights, materials, and updates related to experience performance, escalation trends, and roadmap progress.

  • Support enterprise initiatives by developing business centric experience cases, inclusive of financial considerations, risk, and value realization.

  • Influence senior leaders through clear storytelling, executive ready presentations, and data driven recommendations.

  • Own and advance multiple complex initiatives simultaneously, balancing immediate execution with longer term innovation opportunities.

  • Analyze escalation themes to identify root causes and deliver preventative, sustainable solutions and partner with stakeholders to drive corrective actions across process, policy, product, or operations.

  • Contribute to governance forums, risk discussions, and leadership decision making with clear analysis and recommendations.

  • Model a continuous improvement mindset grounded in member trust, accountability, and measurable outcomes.

Qualifications

Required

  • Bachelor’s degree in Business, Healthcare Administration, Operations, or a related field; or equivalent combination of education and experience.

  • 10+ years of progressive experience leading operations, experience transformation, strategy, and/or process improvement initiatives in complex organizations.

  • Proven track record of leading large, cross functional initiatives end‑to‑end, driving outcomes.

  • Strong business acumen and ability to make connections with broad experience within the member and patient ecosystem.

  • Enterprise level thinker with the ability to influence across matrixed organizations and cultivate strong, trusted relationships with senior leaders and peers.

  • Executive level written and verbal communication skills, with the ability to present complex ideas with confidence and poise to large, senior audiences.

  • Experience operating within healthcare or similarly regulated environments, with strong awareness of compliance, risk, and policy considerations.

  • Advanced ability to influence senior leaders through compelling, data driven narratives that support sound decision making and investment prioritization.

  • Demonstrated self‑starter mindset, with the ability to independently identify opportunities, navigate ambiguity, and execute solutions from concept through delivery.

  • Ability to travel up to 10–15% as needed.

Preferred

  • Experience with Coverage Review, utilization management, or pharmacy/benefit operations.

  • Familiarity with Lean, Six Sigma, or experience design methodologies.

  • Business and financial acumen, including profit and loss considerations.

Candidates who reside within 50 miles of the following locations may be asked to work in person: Bloomfield, CT, Chattanooga, TN, Denver, CO, St Louis, MO, and Scottsdale, AZ.


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 124,800 - 208,000 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.

At The Cigna Group, 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), 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, click here.

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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 need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance.  Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

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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