17 days old

Clinical Program Senior Director, Benefit Operations - Evernorth

Cigna
Memphis, TN 38103
  • Job Code
    21011090
The Clinical Program Senior Director-Benefit Operations is responsible for clinical and benefit configuration within the PBM Client Service & Operations division of Evernorth Service Operations. The Senior Director will deliver a high quality experience for our clients, while driving efficiency and operational improvements to remain cost-effective. This individual will recruit, develop and motivate the team to achieve business objectives and high levels of employee engagement. A highly collaborative and cross-functional leader, the Clinical Program Senior Director will serve as an operational clinical expert to clients, account teams, prospects and product owners offering sound advice on the best way to achieve clinical and affordability outcomes with high quality and efficiency.

This position is with Evernorth, a new business within the Cigna Corporation.

ESSENTIAL FUNCTIONS

  • Manages the following workgroups including both employee and contractor resources:
    • Configuration Delivery Services-Configures drug coverage, formularies, clinical rules and criteria for all PBM lines of business.
    • Medicare-Captures client requirements for and configures all clinical and non-clinical benefits for PBM Medicare clients. Captures requirements for and produces HPMS files for submission by Express Scripts or the client.
    • Client Pricing & Configuration Project Services-Implements client pricing and sub-client pricing for all lines of PBM business. Implement pricing simplification and automation. Support the entire CBS Clinical Program group with automation and other improvement initiatives.
    • Configuration Product-Works with product owners to implement new book of business and custom products to support control of drug trend and spend and margin growth. Supports build and maintenance of formularies for DFO business.
  • Functions as a clinical operations thought leader and subject matter expert. Actively seeks out situations where clinical operations needs to be at the table to help the client or internal team achieve the desired outcome.
  • Champions a culture of continuous improvement and quality management within the Clinical Benefit Operations and beyond. Utilizes metrics to measure progress and focuses on permanent solutions for root causes of issues.
  • Develops and maintains a portfolio of improvement opportunities including technology-based solutions. Builds business cases and sells his/her ideas to impacted and influential stakeholders.
  • Manages vendor relationships for contractor resources to deliver high quality service efficiently.
  • Develops an annual business plan and manages monthly performance to achieve targets. Updates and maintains quarterly forecasts.
  • Fosters a diverse and inclusive environment.
  • Develops talent through and champions a culture of employee development where employees can grow and develop.

QUALIFICATIONS

  • At least 12 years of relevant experience, including leadership experience in PBM clinical operations and strong understanding of ESI clinical benefit and product offerings. Medicare Part D experience is helpful.
  • Bachelor's Degree required. PharmD, MBA and/or MHA are desirable.
  • Experience leading a large team, including leading multiple distinct functions. Proven leadership skills, team-orientation, a proactive management style, and strong commitment to the team and client service are a must.
  • Passion for talent development building high performing teams with strong employee engagement. Ability to effectively change/build culture in the team.
  • Strong operational processes background leading significant process improvements.
  • Experience managing a high volume service operation including use of contracted resources.
  • Excellent presentation and communication skills. Client facing experience is beneficial.
  • Must have the ability to work on multiple tasks, prioritize, resolve complex issues, and have strong project management skills.
  • Must have ability to learn multiple proprietary systems and internal reporting and analytic tools.

This position is not eligible to be performed in Colorado.

About Evernorth

Evernorth, Cigna Corporation's health services segment, exists to elevate health for all. We're building on our legacy and redefining health care as we know it. Unbiased in how we think, we create without limitation. We partner without constraints, deliver value differently and act in the interest of humanity. Solving across silos, closing gaps in care, and empowering clients, customers, and people everywhere to move onward and upward. When you work with us, you'll be empowered to solve the problems others don't, won't or can't. Join us. 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.





Posted: 2021-07-07 Expires: 2021-08-05
Sponsored by:
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Clinical Program Senior Director, Benefit Operations - Evernorth

Cigna
Memphis, TN 38103

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