Clinical Program Senior Manager (Must be a Pharmacist) - Work from Home at Cigna

Posted in General Business 4 days ago.

Type: Full-Time
Location: Bloomfield, Connecticut





Job Description:

Clinical Program Senior Manager

Role Summary:

This position is responsible for the development of formulary strategies involving both pharmacy and medical products, clinical actions following release of new/existing drug products, evaluating and managing drug utilization review, and pipeline product tracking and forecasting. Affordability solutions encompass activities that include utilization management edits at point of service, preferred drug list strategy, retrospective utilization review, risk management review and condition-specific interventions. The position works closely with matrix partners across the medical organization, PBM partners, Contracting, Pharmacy pricing/finance, Clinical Operations, Coverage Policy Unit, Pharmacy and Medical client facing partners, Pharmacy product, Analytics, Compliance, Legal, and Specialty Pharmacy. This position is responsible for the management of the clinical pharmacists who work to support formulary management activities as well as oversight of key functions that the clinical pharmacists are aligned to.

Responsibilities:


  • Lead a team of clinical pharmacists with day to day formulary management activities

  • Execute formulary management strategies for major specialty and non-specialty drug classes across the pharmacy and medical benefit, including designing and implementing specific actions and workflows to drive affordability and meet quarterly targets

  • Evaluate the success of current utilization management program to determine areas of enhancement

  • Monitor market share leakage for high cost drugs and implement strategies to address leakage and waste in the commercial population

  • Provide support to the condition based program managers to enhance clinical affordability and total health outcomes


  • Provide education and training for clinical teams (Pharmacy Service Center, Home Delivery, Specialty Pharmacy, Medical Management) to communicate clinical strategy and actions and assure consistent execution of class strategy

  • Responsible for the oversight of the review and audit of all Business Decision Team recommendations/decisions to ensure all formularies are compliant with P&T guideline

  • Responsible for the oversight of all state audits to ensure that the formulary management process and decisions of the Business Decision Team are in line with state regulations

  • Responsible for post-implementation affordability monitoring related to clinical issues resulting in loss of affordability

  • Responsible for the oversight of the new drug management process for pharmacy and medical drugs

  • Partners with business process team on development and maintenance of formulary charters/SOPS/process mapping

  • Responsible for the oversight and monitoring of clinical research tasks to support the formulary strategy leads

  • Responsible for the oversight of periodic auditing and maintenance of existing drug lists related to compliance/legal mandates, product, and back-end formulary maintenance logic

  • Responsible for engaging with matrix partners to identify potential impacts to formulary strategies




Qualifications:

  • PharmD required

  • Licensed Pharmacist required

  • Previous management experience required

  • Experience developing end to end Pharmacy Clinical Programs recommended

  • Minimum of 5 years Clinical Pharmacy experience required, preferably in a Pharmacy Benefit Management (PBM) or similar clinical practice environment

  • Proven capabilities in strategic planning and clinical program development required

  • Solid understanding of evidence based medicine, interpreting clinical literature, and standards of care required

  • Demonstrated ability to work in a highly matrixed environment

  • Demonstrated ability to present to and engage with senior leaders

  • Results driven with proven communication, interpersonal and collaboration skills working in a cross-functional and matrixed environment require

For this position, we anticipate offering an annual salary of $114,700 - $191,100, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

Helping our customers achieve healthier, more secure lives is at the heart of what we do. While you take care of our customers, we'll take care of you through a comprehensive benefits program that helps you be at your best. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and best in class 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 dozens of corporate discounts on essentials you use every day. For more details on our employee benefits programs, please visit the "Life at Cigna" tab on our careersite: www.cigna.com/careers

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives. What difference will you make?

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.

Cigna 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.





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