Clinical Program Strategist - Formulary & Rebates

Cigna Healthcare

Bloomington (IN)

On-site

USD 96,000 - 159,000

Full time

10 days ago

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Benefits offered by this job

Health benefits

401(k) matching

Tuition reimbursement

Paid time off

Job summary

Cigna Healthcare is seeking a Clinical Program Advisor to interpret rebate contracts and utilization management criteria, ensuring accurate rebate invoicing and formulary positioning. The role involves cross‑functional collaboration with contracting, clinical consulting and invoicing teams to align client strategies with clinical rules.

The position requires a PharmD or BS in Pharmacy, active U.S. pharmacist license, and experience in PBM/healthcare industries.

Qualifications

Pharmacist degree and U.S. licensure.
Experience in PBM, pharmaceutical and healthcare industry.
Knowledge of Medicare/Medicaid pharmacy benefits.
Experience with pharmaceutical contracts and pharmacy benefits.
Experience with clinical utilization criteria evaluation.
Excellent presentation and communication skills.
Ability to manage multiple tasks and prioritize.
Detail-oriented with strong organizational skills.
Ability to work independently and adapt quickly.

Responsibilities

Review, interpret, and evaluate utilization management criteria to align with rebate contracts.
Provide quality assurance evaluations for rebate invoicing.
Collaborate with Contracting, Clinical Consulting and Invoicing teams to interpret formulary and clinical rules.
Assess formulary placement and utilization management policy impacts.
Offer consultative support on rebate requirements and proposed changes.