Clinical Program Advisor - Express Scripts - Remote (Centene)

Cigna Health and Life Insurance Company; New Jersey; Hybrid; USD 96,000 - 159,000; Full time

Benefits offered by this job

Medical

Vision

Dental

Well-being programs

401(k)

Life insurance

Tuition reimbursement

Paid time off

Holidays

Leaves of absence

Annual bonus plan

Job summary

Cigna Health and Life Insurance Company is seeking a seasoned Clinical Program Manager to counsel top management on major program initiatives and coordinate cross-team efforts. You will lead strategic projects, mentor teammates, and act as a trusted adviser to clients and sales teams to improve care coordination and outcomes.

Join Evernorth Health Services, a division of The Cigna Group, to drive value-based healthcare solutions, educate stakeholders, and deliver services that enhance cost,

Qualifications

• Current U.S. Pharmacist License, Pharm.D. Managed care, the PBM industry, or pharmaceutical sales preferred.
• Proven leadership skills, team-orientation, a proactive management style and strong commitment to client service.
• Knowledge of PBM industry/Managed care/Value Based healthcare desirable.

Responsibilities

• Act as a SME in areas relevant to the team and lead/coach team members.
• Lead and execute large strategic projects to enhance operating effectiveness and change.
• Identify business improvement opportunities using data, feedback and analysis.
• Develop, prepare, and present project plans and client deliverables.

Skills

Multitasking

Excel

Access

Communication

Collaboration

Analytical thinking

Organization

Results-oriented

Project management

Reporting tools

Education

Pharm.D.

Pharmacist License (US)

Job description

Provides counsel and advice to top management on significant Clinical Program Management matters, often requiring coordination between organizations. Focuses on providing thought leadership and technical expertise across multiple disciplines. Recognized internally as “the go-to person” for the most complex Clinical Program Management assignments. Represents company externally and serves as conduit to educate and enable care coordination between stakeholders resulting in an optimal healthcare experience and customer satisfaction. Serves as clinical advisor to the sales organization, providing ongoing product and industry knowledge/education that positively influence cost, quality and customer satisfaction.

Essential Functions

Act as a subject matter expert (SME) in areas relevant to the team. Leads, coaches, and develops by providing mentorship to members within the team. Acts as a strategic business partner to various stakeholders both internal/external. Lead and execute large strategic projects designed to enhance operating effectiveness and drive overall change. Identify business improvement opportunities using data, feedback, and analysis. Execute and deliver processes with a forward thinking ability to present solutions and identify efficiencies. Participates and contributes in formal and informal training programs and professional development activities which may include taking, developing, and/or conducting sessions. Serve as business owner to necessary client work that involve operational and implementation benefits changes. Understand client's existing clinical benefit and business philosophy to help avoid unnecessary clarifications. Accurately capture and document clinical benefit requirements in collaboration with business stakeholders. Provide excellent customer service and act as a trusted client advisor. Work with internal partners to ensure all implications of requested clinical benefit requirements are vetted, understood and communicated as necessary. Consult with team members, SMEs and specialized teams as necessary, Client Benefit Administrators (CBA), Clinical Application Teams (DCRS, FRS, CRS, Criteria), Account Teams, Product Owners. Manages and tracks all requests to ensure timelines are met. Develop a deep understanding of claims adjudication system and associated clinical applications. Leads the development, preparation, and presentation of project plan including execution and delivery for each client(s) assigned.

Skills

• Ability to multitask and communicate effectively.
• Microsoft office with a strong understanding of Excel and Access
• Written and verbal communication (listening, feedback; translating complex ideas/processes), collaboration, analytical thinking/critical thinking, results-oriented and organizational skills
• Must have the ability to work on multiple tasks, prioritize, resolve complex issues, and have strong project management skills
• Ability to learn multiple internal reporting and analytic tools for client management
• Provide project and administrative support to the team and escalated issues, risks, concerns as needed.
• Medicare experience preferred but not required.

Education and Qualifications

• Current U.S. Pharmacist License, Pharm.D. Managed care, the Pharmacy Benefit Manger (PBM) industry, or pharmaceutical sales preferred.
• Proven leadership skills, team-orientation, a proactive management style and strong commitment to client service a must.
• Knowledge of PBM industry/Managed care/Value Based healthcare industry is desirable.

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 95,500 - 159,100 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 plan.

Benefits

• medical
• vision
• dental
• well-being and behavioral health programs.
• 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.
• annual bonus plan.

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.

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.

EEO/DEI

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.