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March 13 (Reuters) - Healthcare conglomerate Cigna CI.N appointed Chief Financial Officer Brian Evanko to the newly created position of chief operating officer and promoted his deputy, Ann Dennison, to the top finance role, in a major shakeup unveiled on Thursday.

Eric Palmer, the head of its Evernorth Health Services unit, which primarily houses the pharmacy benefit management $(PBM)$ business, will leave by the end of April after a 25-year tenure.

"These leadership changes create a sharpened structure to build upon our strengths for continued growth, enhance our customer focus, and deliver even greater value for those we serve," CEO David Cordani said in a statement.

Cigna is grappling with an industry-wide jump in medical costs. The insurer, which relies more on its PBM and commercial health insurance businesses, expects such costs to remain higher this year after missing profit estimates for the fourth quarter.

PBMs negotiate drug prices with manufacturers on behalf of employers and health plan clients.

Cigna said last month it would link executive compensation to customer satisfaction and hire more staff in people-facing roles as part of sweeping measures to address widespread criticism over medical care denials and delays.

Evanko, who has been CFO since 2021, will take over as Cigna's president and chief operating officer from the end of March, the company said on Thursday.

The promotion "clearly positions" Evanko as next in line to CEO Cordani, Stephens analyst Scott Fidel said.

Cordani, who joined the company in 1991, was appointed to the top role in 2009.

As COO, Evanko will oversee Cigna's Evernorth unit as well as its healthcare unit, which offers medical plans to clients and customers.

Dennison joined Cigna last year from Nasdaq NDAQ.O.

(Reporting by Manas Mishra and Mariam Sunny in Bengaluru; Editing by Leroy Leo and Sriraj Kalluvila)

((Mariam.ESunny@thomsonreuters.com;))