- Location
- MO, St. Louis, One Express Way, United States of America
- Workplace
- Hybrid
- Type
- Full-time
- Department
- IT
- Seniority
- Senior
- Closing date
- Today
- Source
- Workday
Description
SUMMARY:
The successful individual in this role will have a deep understanding of pharmacy benefits, strong analytic skills, communication, leadership, project ownership, research and decision-making skills. Managing complex cases to timely "should we" decisions and ensuring leadership is aligned with all decisions.
RESPONSIBILITIES:
Troubleshoot client and internal questions regarding pharmacy networks while providing clear and concise responses based on findings.
Accountable for gathering appropriate stakeholders to make timely "should we" approve/deny decisions, based on thorough consideration and discussion.
Oversee product solutions and evolutions
Effectively escalate requests as needed to Product leadership and/or Sales leadership for appropriate decision making.
Engage pharmacy subject matter experts when applicable from pricing, underwriting, rebates, implementations, operations, clinical management, legal, compliance, IT, and other strategic partners to drive to an approve/deny decision that supports Cigna Pharmacy Management’s overall strategic goals and priorities.
Fully understand and be able to articulate all Benefit, System and Product standards for all supported Cigna Pharmacy solutions.
Serve as a pharmacy product subject matter expert to assess any downstream (and upstream) impacts so that non-standard solutions are being fully thought through end-to-end.
Influence change to simplify interactions and improve E2E processes..
Oversee a team to ensure all current products, projects, and ad-hoc requests are being managed timely and effectively.
IDEAL CANDIDATES WILL HAVE A COMBINATION OF THE FOLLOWING:
Bachelor’s degree preferred, or equivalent work experience in a pharmacy-related field.
5+ years of pharmacy benefit management (PBM) experience, preferably supporting Commercial health plans.
Working knowledge of pharmacy-specific federal and state regulations.
Demonstrated knowledge of pharmacy products, benefits, and programs, including an understanding of platform and system nuances across multiple operational environments.
Strong knowledge of and experience with pharmacy network operations.
Strong analytical, problem-solving, and technical skills, with the ability to assess business needs, evaluate alternatives, and develop effective solutions.
Ability to understand and navigate the interdependencies between technology capabilities, system functionality, and business processes.
Experience analyzing information, assessing impacts and risks, and recommending process improvements and practical solutions.
Working knowledge of health benefit installation systems, processes, and claims adjudication.
Proficiency with Microsoft Office applications; experience with ePro, CIT, BST, or similar business systems preferred.
Proven ability to work independently, manage multiple priorities, meet service level commitments, and thrive in a fast-paced environment.
Strong decision-making skills with a high degree of initiative, accountability, and attention to detail.
Demonstrated ability to communicate effectively and influence stakeholders at all levels of the organization.
Ability to collaborate consultatively with peers, cross-functional partners, and leadership to achieve business objectives.
Proven track record of building partnerships, valuing diverse perspectives, and gaining support across multiple business areas.
Experience leading teams and fostering an inclusive, collaborative culture that drives enterprise-wide value and results.
Demonstrated success working with remote and geographically dispersed teams to achieve shared goals and objectives.
Self-starter with a strong work ethic, sense of urgency, and commitment to delivering high-quality outcomes.
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.
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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 [email protected] 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.
