Note: The job is a remote job and is open to candidates in USA. The Cigna Group provides pharmacy, care, and benefit solutions through Evernorth Health Services and Express Scripts. The Program Management Advisor will consult with custom formulary clients, interpret rebate contracts, perform financial modeling, evaluate scenarios, and identify strategies to optimize formularies. The role also involves client presentations, cross-functional collaboration, utilization management discussions, and process improvement.
Responsibilities
- Provide consultation through rebate contract interpretation and strategic opportunity identification
- Meet directly with large and 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
- Collaborate with Clinical Account Executives to create strategy for Custom Clients based on formulary scenarios, rebate offerings, and modeling options
- 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
- Participate in 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
Skills
- 2-4 years relevant work experience in PBM, Managed Care, Healthcare or Finance
- Confidence, Detail Oriented Organizational, and Analytical skills
- Excellent PC skills – including Excel, PowerPoint and MS Access, experience with database
- Must have expertise in Excel
- Financial modeling experience
- Proven ability to work in a fast paced – ever changing environment
- Excellent relationship building and cross functional skills
- Ability to travel approximately 10%
- Bachelor Degree, Finance, Healthcare or related area/MBA a plus
- Pharm D a plus
- Familiarity with pharmaceutical rebate contracts a plus
Benefits
- Hybrid work arrangement: 3 days per week in-office and 2 days' work at home
- Annual bonus plan eligibility
- 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
Company Overview