Clinical Program Advisor at Cigna in Bloomfield, Connecticut

Job Description:

Essential Functions

• Responsible for the successful implementation/renewal of existing client clinical programs, complete understanding of Express Script's clinical Medicare portfolio


• Responsible for managing multiple cross-functional workflows/initiatives along with Vendor Management


• Work directly with client as needed for gathering of requirements and support of clinical benefit changes


• Identify and document client requirements and complete clinical portion of intake/project plans


• Act as a subject matter expert (SME) in areas relevant to the team


• Develop strategic relationships/matrix with Clinical Operations and other Express Scripts leaders


• Leads, coaches, and develops by providing mentorship to members within the team


• Acts as a strategic business partner to various stakeholders both internal/external


• Lead and execute large strategic projects designed to enhance operating effectiveness and drive overall change


• Identify business improvement opportunities using data, feedback, and analysis


• Execute and deliver processes with a forward thinking ability to present solutions and identify efficiencies


• Participates and contributes in formal and informal training programs and professional development activities which may include taking, developing, and/or conducting sessions


• Serve as business owner to necessary client work that involve operational and implementation benefits changes


• Understand client's existing clinical benefit and business philosophy to help avoid unnecessary clarifications


• Accurately capture and document clinical benefit requirements in collaboration with business stakeholders


• Provide excellent customer service and act as a trusted client advisor


• Work with internal partners to ensure all implications of requested clinical benefit requirements are vetted, understood and communicated as necessary


• Provide operational Subject Matter Expertise (SME) to Clinical Account Executives/Implementation Manager (CAE/IPM's), Client Benefit Administrators (CBA), Clinical Application Teams (DCRS, FRS, CRS, Criteria), Product Owners


• Manages and tracks all requests to ensure timelines are met


• Develop a deep understanding of claims adjudication system and associated clinical applications


• Leads the development, preparation, and presentation of project plan including execution and delivery for each client(s) assigned

Education and Qualifications

• Current U.S. Pharmacist License, Pharm.D.


• At least 3 years' pharmacy experience and 3+ years in managed care (Medicare preferred)


• PBM industry, or pharmaceutical sales preferred


• Proven leadership skills, team-orientation, a proactive management style and strong commitment to client service a must


• Ability to work with cross functional committees or workgroups


• Able to manage multiple tasks and prioritization; able to function under stressful situations


• Must have strong commitment to clinical services and company goals


• Microsoft office with a strong understanding of Excel and Access


• Written and verbal communication (listening, feedback; translating complexideas/processes), collaboration, analytical thinking/critical thinking,results-oriented and organizational skills


• Must have the ability to resolve complex issues, and have strong project management skills


• Ability to learn multiple internal reporting and analytic tools for client management


• Provide project and administrative support to the team and escalate issues, risks, concerns as needed

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 92,700 - 154,500 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.

We want you to be healthy, balanced, and feel secure. That's why 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) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group .

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 require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

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.