The Chief Pharmacy Lead oversees and directs the creation, adoption and evaluation of clinical pharmacy programs, product and services that are capable of achieving the Cigna Integrated Health Plan strategic clinical and financial goals. Ensures that solutions meet traditional PBM affordability goals while accelerating differentiated Total Cost of Care reductions through integration with other Health Plan and Enterprise capabilities, which may be delivered through operations across the Health Plan and Health Services organizations. Exercises final accountability for the clinical integrity of Health Plan pharmacy lowest net cost offering. Manage applicable matrixed teams' work, such as clinical operations and coaching teams, tied to affordability strategies and new clinical solutions.
RESPONSIBILITIES:
Ensures clinically based program affordability:
Leader of the Value Assessment Committee for Cigna ensuring consistency with overall Health Services processes while maintaining Cigna Health Plan lowest net cost drug management.
Partners with Health Plan and Health Services Product teams and Supply Chain to evaluate and deploy available Health Services solutions that meet Health Plan clinical and affordability goals.
Oversees the creation and modification of Health Plan formularies and utilization management programs and ensures that such are aligned within the broader Enterprise Pharmacy and Therapeutics Committee.
Provides clinical and contextual insights to partners within Health Plan finance, underwriting, and risk-bearing products to ensure that emerging therapeutics and revisions to the US drug supply are accurately reflected in financial projections (trend, underwriting, and pricing).
Develops differentiated prescription drug benefit affordability capabilities that meet the unique needs of the buying groups and funding types within the Health Plan book of business.
Partners with the Health Plan National Medical Officer for Pharmacy to develop and deploy clinical affordability solutions for drugs and biologics covered under the Medical Benefit.
Champions and develops clinical solutions, in partnership with applicable plan and/or enterprise teams, which has impactful ROI for conditions associated with significant drug spend.
Set pharmacy clinical strategy and creates next generation programs:
Leader of Clinical Steering Committee for Cigna ensuring promotion of appropriate clinical pharmacy activities and partners with Health Plan Policy Committee to set appropriate drug policies.
Champions and develops fully integrated medical and pharmacy solutions that are capable of achieving drug-driven reductions in Total Cost of Care or improvement in Total Health Outcomes.
Leads review, update and/or elimination of existing clinical solutions, product, and services based on cost and health outcomes analysis.
Serves as the Health Plan pharmacy leader for relevant Health Plan cross-functional condition-based clinical initiatives.
Partners with the Global Data & Analytics team to develop program performance analytics and methodologies.
Partners with Cigna International Markets to address barriers with pharmacy management and provide clinical drug management support in their drug program development.
Partner with Health Services to elevate and test innovative new clinical concepts and/or vendors that promote improved affordability, health outcomes and experience.
Collaborates with Cigna Ventures to identify and evaluate digital health, startup company and investment opportunities to advance Cigna Pharmacy services.
Matrix management of key internal partner teams:
Provides oversight of clinical operations that support formulary/UM strategies, working closely with Cigna Pharmacy project management delivery team.
Plan oversight and priority setting of projects performed by the clinical coaching teams (CoachRx and SCC) to support integrated programs and affordability Initiatives.
Provides leadership to manage specialty pharmacy market dynamics.
Leads pharmacy policy and quality improvement initiatives:
Contributes to and support Cigna and enterprise pharmacy specific clinically integrated quality initiatives.
Ensures the clinical integrity of the Health Plan pharmacy offering and completes associated regulatory attestations as required.
Works with Federal/State government affairs as needed in health plan drug-related issues to foster a favorable regulatory environment.
Ensure regulatory compliance for clinically related matters, including final signatory authority for specified attestations and filings, including the IFP segment.
Builds, develops and inspires a high performing pharmacy team and culture:
Creates a sense of purpose/meaning for the team that aligns with Cigna's value and mission.
Supports and promotes appropriate team alignment and process improvement work.
Provides coaching and development to teams, in particular, direct reports for succession planning and overall career growth.
Fosters an effective work environment and ensures employees receive appropriate communication, recognition and development.
Represents Cigna Pharmacy to key external stakeholders:
Provides as needed clinical support to the Integrated Health Plan pharmacy client-facing teams.
Presents and represents Cigna Pharmacy at key client forums, media, conferences and other meetings as needed.
REQUIRED SKILLS:
Registered Pharmacist required with active licensure in a US state or territory; MBA preferred.
Previous pharmacy experience at the retail or direct care level.
Minimum of 10 years' experience in the healthcare industry, with focus on Pharmacy Health Plan or Pharmacy Benefit Management.
Minimum of 5 years of senior leadership experience.
Proven capabilities in strategic planning and large-scale project management.
Demonstrated ability to think/act strategically from a program value perspective and influence key leaders and matrix partners.
Demonstrated ability to work in a highly matrixed environment.
Strong communication and facilitation skills with all levels of the organization, including ability to resolve issues and build consensus among groups of diverse internal/external stakeholders.
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 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.
