Quality & Performance Assurance Director, Client Service & Operations - Evernorth - Remote

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.

Role Summary 

The Director of Quality & Performance Assurance, reporting to the Senior Director Client Operations Enablement, is responsible for leading and modernizing the Client Service & Operations quality ecosystem through a risk-aligned, data-informed, and performance-driven approach. This leader will evolve the function beyond traditional inspection and audit activity into an integrated quality management capability that strengthens operational integrity, improves business performance, and enables scalable growth.

This role will partner closely with Operational Risk & Controls Governance, SOC1/SOX Measurement Operations, Client Operations leadership, and Operations Enablement to ensure quality programs are aligned to enterprise risk, control effectiveness, operational readiness, and continuous improvement priorities.

The ideal candidate is a strategic quality leader with deep operational quality expertise, strong business acumen, and demonstrated success modernizing quality programs, simplifying complex ecosystems, implementing scalable governance models, and leveraging technology and automation to improve effectiveness and efficiency.

Key Responsibilities

Quality Strategy & Operating Model Modernization

• Lead the transformation of the quality function from a traditional inspection-based model to a modern, risk-aligned quality management system.

• Design and maintain a quality framework aligned to operational, client, regulatory, and financial risk priorities.

• Rationalize and simplify existing quality programs, identifying opportunities to eliminate redundancy, consolidate overlapping activities, and improve effectiveness.

• Establish a scalable quality operating model that supports both peak-season execution and long-term continuous improvement.

Risk-Aligned Quality Governance

• Partner with Operational Risk & Controls Governance leadership to align quality programs to operational risks, control objectives, and enterprise governance expectations.

• Ensure quality activities and inspection strategies support the validation of critical operational controls and business outcomes.

• Collaborate with SOC1/SOX Measurement Operations to ensure appropriate integration and delineation between formal control measurement activities and broader operational quality programs.

• Maintain clear mapping between risks, controls, quality programs, and validation methodologies.

Quality Program Optimization & Effectiveness

• Evaluate effectiveness of current quality programs, methodologies, tooling, and sampling approaches.

• Establish standardized quality methodologies, calibration practices, governance routines, and quality effectiveness measures.

• Define quality standards and measurable success criteria across all quality programs and reviewer populations.

• Lead proactive root cause analysis and trend identification efforts to reduce operational defects and improve prevention strategies.

Quality Technology & Innovation

• Drive modernization of quality tooling, automation, and AI-enabled quality capabilities.

• Evaluate opportunities for workflow automation, intelligent sampling, Copilot/agentic AI solutions, and digital quality management technologies.

• Partner with technology and business teams to pilot and scale innovative quality solutions that improve efficiency and insight generation.

Performance Insights & Business Partnership

• Deliver actionable quality insights and risk intelligence to operational and executive leadership.

• Serve as a strategic advisor to business leaders on operational quality trends, risk exposure, process performance, and readiness implications.

• Partner with all Enablement functions (e.g., Learning Strategy, Training, Coaching, Knowledge and Content Management) to strengthen feedback loops between quality findings and performance improvement actions.

Organizational Leadership & Capability Development

• Lead and develop a high-performing quality organization focused on operational excellence, analytical rigor, strategic thinking, and business partnership.

• Clarify role expectations, capability models, and performance standards across quality reviewers, supervisors, managers, and senior leadership roles.

• Optimize workforce utilization, capacity planning, and talent strategy across seasonal and non-peak operational periods.

• Foster a culture of accountability, continuous improvement, innovation, and simplification.

Required Skills and Qualifications

• Bachelor’s degree required; advanced degree preferred.

• 8+ years of experience in operational quality, quality management systems, operational risk, performance assurance, compliance, or operational excellence leadership.

• Experience leading quality transformation initiatives involving automation, digital workflows, AI-enabled quality capabilities, or other advanced technologies.

• Proven experience establishing calibration frameworks, governance models, and measurement standards across complex operational environments.

• Demonstrated success building, redesigning, or modernizing quality management systems (QMS) at scale.

• Strong experience aligning quality programs to operational risk, governance, and control environments.

• Experience leading cross-functional quality improvement and operational transformation initiatives.

• Ability to translate complex operational quality findings into executive-level insights, business recommendations, and strategic action plans.

• Strong analytical, root cause analysis, and process optimization expertise.

• Strong executive communication and stakeholder management skills.

• Knowledge of SOC1/SOX control environments and operational risk governance models.

• Ability to travel up to 25% as needed.

Preferred Qualifications

• Experience operating in regulated, highly complex enterprise environments.

• Lean Six Sigma or equivalent process improvement certification.

• Experience supporting audit, regulatory, or enterprise governance initiatives.

• Experience with AI-enabled quality assurance, workflow automation, or intelligent operations technologies.

The successful candidate will:

• Challenge legacy approaches and lead meaningful transformation

• Emotional intelligence

• Lead and partner with high levels of emotional intelligence, building trust, credibility, and strong cross-functional partnerships

• Balance risk mitigation with operational simplicity

• Drive modernization without disrupting operational integrity

• Create measurable improvements in quality effectiveness, operational insight, and business confidence

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 136,900 - 228,100 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, paid holidays, and leaves of absence. 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.

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.