Clinical Program Advisor - Express Scripts - Hybrid (Rebate Optimization)

Program Management Clinical Advisor

Benefit Driven Rebate Optimization

Overview
Benefit Driven Rebate Optimization works cross functionally with a variety of business partners to manage client rebate eligibility for our full service and externally adjudicated clients. Our Mission is to perform timely and accurate review of drug rebate eligibility based on the interpretation of applicable clinical drug policies and clients' benefit coverage against the corresponding pharmaceutical manufacturer contract requirements. This role is integral to ensuring proper rebate invoicing set up to drive the best outcomes for all parties involved.

Responsibilities

• Work cross-functionally with Pharma Contracting, Formulary Consulting, Clinical Account Executives and Pharma Invoicing to assure appropriate interpretation of clinical rules and benefit set up impacts on rebated drug products
• Provide clinical support in documentation of appropriate policies and procedures for analysis and appropriate determination of client eligibility for rebate enhancement and exclusion options.
• Provides clinical/professional support for Benefit Driven Rebate Optimization assignments and/or projects.
• Provide consultative clinical support in the interpretation of rebate requirements contained within manufacturer rebate agreements.
• Provide consultative support determining rebate impacts due to considered changes to formulary and benefits on rebate eligible products
• Other duties as deemed essential by business to support rebates optimization process.

Qualifications

• B.S. Pharmacy or PharmD
• 1-2 years of benefit analysis in PBM industry. CAE or CPM experience a major plus
• Pharmacist License required
• Excellent PC skills including Microsoft Office with a high degree of proficiency in Access and Excel required. Familiarity with SQL would be considered a strong plus.
• Excellent problem solving and communication skills required. Must be able to work under pressure and perform continual follow up in a timely manner in order to meet tight deadlines.

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 95,100 - 158,500 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: [email protected] for support. Do not email [email protected] 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.