Note: The job is a remote job and is open to candidates in USA. The Cigna Group’s Evernorth Health Services provides pharmacy, care, and benefit solutions to improve health and increase vitality. The Clinical Program Advisor reviews and evaluates utilization management criteria, formulary strategies, and pharmaceutical rebate requirements while providing clinical consultation and quality assurance for accurate rebate invoicing. The role collaborates with pharmaceutical contracting, clinical consulting, invoicing, account management, and clients on clinical initiatives, impact assessments, formulary maintenance, and implementation.
Responsibilities
- Support client with formulary, rebate, and utilization management strategies to service all current and future needs
- Participate in Clinical Program team functions, including maintaining formulary status changes for all actively maintained formularies, assessing utilization management policy updates, and consulting on anticipated clinical and financial impacts of strategies under consideration by the client
- Keep abreast with industry pipelines, such as new drugs, patent expirations, generic and biosimilar approvals and launch dates, etc
- Act in concert with internal teams, such as Account Management, to service all needs of the client
- Participate in developing tools and training for carrying out goals of work plans, including continuous process improvement activities
- Represent the strategic market division as a point of contact for various corporate clinical initiatives, including participation in client meetings
Skills
- B.S. in Pharmacy with experience or Doctor of Pharmacy
- Current U.S. pharmacist license
- Experience in PBM, Pharmaceutical and Healthcare industry
- Good to have – General knowledge of Medicare and/or Medicaid pharmacy benefits
- Excellent presentation and communication skills required
- Successfully function while handling multiple tasks and ability to prioritize
- Detail-oriented with strong organizational skills
- Ability to adapt to a dynamic work environment and learn quickly, solve problems, and make decisions with minimal assistance or direction from leader when interfacing clients and other internal partners
- Ability to work independently and prioritize work to meet client needs
- Proficiency in Microsoft Office applications required
- Experience with Pharmaceutical Contracts and Pharmacy Benefits strongly preferred
- Experience with clinical utilization criteria evaluation strongly preferred
Benefits
- Eligibility to participate in an annual bonus plan
- Medical benefits starting on day one of employment
- Vision benefits starting on day one of employment
- Dental benefits starting on day one of employment
- Well-being and behavioral health programs starting on day one of employment
- 401(k)
- Company paid life insurance
- Tuition reimbursement
- A minimum of 18 days of paid time off per year
- Paid holidays
- Leaves of absence
- Hybrid work arrangement
Company Overview