Job description

The Partnerships & Controls Director, Provider Organisation IHDS at Cigna International Health is responsible for designing and executing robust control frameworks, performance oversight mechanisms, and partnership standards across international markets to ensure operational integrity, quality delivery, and achievement of annual savings targets. The role oversees Pre-Authorization, Claims Management, Reconciliation, Network, and Counter Fraud, Waste and Abuse functions while strengthening accountability and collaboration with TPAs, Cigna Links, and external partners. The position leads the design and implementation of control frameworks that reinforce sound decision-making and operational integrity, manages closed file review (CFR) campaigns, drives continuous process improvements across Provider, Member, and Clinical domains, and implements quality assurance initiatives aligned to internal standards. The Director develops and maintains financial and operational control mechanisms supporting IH and IHDS savings targets, monitors performance trends and risk exposure, validates workforce and vendor utilisation against budgets, and establishes standards for resource allocation and forecasting. The role develops health services control structures promoting evidence-based practices, cost-effective care delivery, utilization management, case management, and quality improvement programs while reducing avoidable medical costs. Responsibilities extend to defining control standards for provider contracting and partnership agreements, overseeing Cigna Links, validating contractual adherence, monitoring KPIs, establishing controls for provider call centre operations, GOP, claims management, reconciliation processes, workflow automation, system validation rules, dashboards, fraud, waste and abuse safeguards, analytics, detection, sampling, and recovery methods. The role provides high visibility engagement with International Health SLT, CEOs, COO IHDS, and IHDS SLT, influencing global operational strategy, partnership governance, and performance improvement across international regions.