Sr. Clinical Program Advisor - Express Scripts - Hybrid - (Strategy & Financial Analysis)

Express Scripts Pharmacy Benefit Services; United States; On-site; USD 116,000 - 194,000; Full time

Benefits offered by this job

Annual bonus plan

Job summary

Express Scripts Pharmacy Benefit Services in Bloomington, MN seeks a Senior Advisor, Strategy & Financial Analysis to provide consultation on formulary contracts and rebate modeling. You will identify strategic opportunities to optimize client formulary value and lead cross-functional projects.

This role partners with Clinical Account Executives to craft strategies, develop complex rebate models, and present recommendations to senior client stakeholders. Travel around 10% may be required.

Qualifications

• Bachelor’s degree required in Pharmacy, Finance, Healthcare or related area.
• Pharm.D./MBA is a plus.
• 5+ years in PBM/Managed Care/Healthcare/Finance.
• 4+ years in formulary management/development.
• Strong leadership and analytical skills.
• Proficient Excel, PowerPoint and MS Access; financial modeling experience.

Responsibilities

• Provide consultation and through rebate contract interpretation and strategic opportunity identification.
• Mentor Advisors and Lead Analysts to support department training needs.
• Meet directly with large and complex clients to review modeling and cultivate relationships with formulary decision makers.
• Evaluate client data, create scenarios, and provide expert formulary modeling guidance for existing clients.
• Collaborate with Clinical Account Executives to create strategy for Custom Clients based on formulary scenarios and modeling options.
• Develop and execute formulary modeling for complex RFP requests for prospect clients and renewals.
• Discuss potential utilization management programs with clients to ensure modeling aligns with rebates.
• Analyze financial impact of formulary changes to client and Express Scripts.
• Create presentations for client formulary strategy meetings with supporting docs.
• Strategize with cross-functional areas: Account Management, Pricing, Product, Finance, New Sales.
• Lead interdepartmental calls on rebate invoicing terms/conditions.
• Document and communicate formulary analysis projects and model maintenance.

Skills

Leadership

Analytical skills

Financial modeling

Detail oriented

Cross-functional collaboration

Education

Bachelor’s degree in Pharmacy, Finance, Healthcare or related area

Pharm.D./MBA a plus

Tools

Excel

PowerPoint

MS Access

Job description

Position Summary

The Senior Advisor, Strategy & Financial Analysis will provide consultation to custom formulary clients through contract interpretation and rebate financial modeling. As a Sr. Advisor, you will have the opportunity to identify strategic opportunities for clients to optimize their formulary to drive value for both internal and external organizations. Works collaboratively with cross functional teams and may lead interdepartmental teams or projects to drive process improvements. Internally recognized and trusted as the formulary rebate modeling subject matter expert.

Essential Functions

• Provide consultation and through rebate contract interpretation and strategic opportunity identification
• Mentor Advisors and Lead Analysts to help support department training needs
• Meet directly with large and most complex custom clients to review modeling and cultivate relationships with Formulary Decision Makers (i.e. Pharmacy Directors, VP’s, etc.).
• Evaluate client data, create scenarios, and provide expert formulary modeling and guidance for existing clients in alignment with department strategic objectives that drive value to both clients and ESI.
• Collaborate with Clinical Account Executives to create strategy for Custom Clients based on formulary scenarios, rebate offerings, and modeling options.
• Develop and execute formulary modeling for complex RFP requests- prospect clients and client renewals in alignment with department strategy
• In collaboration with Clinical Account Executives discuss with clients any potential utilization management programs under evaluation to ensure that all modeling and requirements of these programs are accurately represented and in alignment with Pharmaceutical rebate contract.
• Analyze the financial impact of client requested formulary changes to both the client and Express Scripts.
• Create presentations for client formulary strategy and/or consulting meetings including all supporting documentation.
• Strategize with cross-functional areas of Express Scripts, including but not limited to Account Management, Pricing, Product, Finance, and New Sales.
• Lead interdepartmental team calls as required to discuss rebate invoicing eligibility terms/conditions.
• Effectively document and communicate formulary analysis projects. (i.e., model maintenance and QC).
• Ensures optimization of work processes for formulary modeling strategies and achievement of department goals

Qualifications

• Bachelor’s degree in Pharmacy, Finance, Healthcare or related area
• Pharm.D./MBA a plus
• 5+ years relevant work experience in PBM, Managed Care, Healthcare, or Finance
• 4 years of significant formulary management/development experience
• Strong Leadership, Detail Oriented Organizational, and Analytical skills
• Excellent PC skills – including Excel, PowerPoint and MS Access, experience with database
• Financial modeling experience
• Familiarity with pharmaceutical rebate contracts a plus
• Proven ability to work in a fast paced – ever changing environment
• Excellent relationship building and cross functional skills
• Ability to travel approximately 10%.

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 116,100 - 193,500 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.

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,

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.

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.

If you need a reasonable accommodation to complete the online application process, please email [e-mail] for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

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.