Clinical Program Advisor - Express Scripts - Hybrid (Commercial Formulary Solutions)

Job Profile Summary

The Clinical Advisor, Formulary Solutions is responsible for assisting with the strategic formulary development and maintenance of our Express Scripts Standard Commercial Formularies as well as Marketplace Formulary consultation. An emphasis will be placed on creating financial models to evaluate optimum formulary value within established clinical guidance. This role will work cross-functionally with Pharma Contracting, Sales & Account Management, Regulated Markets, and Finance partners.

Essential Functions

• Collaborate with our Institute for Clinical Guidance and Oversight in conjunction with Pharma Contracting & Strategy partners to identify strategic formulary opportunities, requiring expertise in contract interpretation
• Provide expert standard Commercial formulary modeling and present recommendations to Value Assessment Committee
• Ensure monitoring of selected modeling scenarios post formulary implementation
• Execute formulary management strategies including Competitive Product Category analysis, utilization management interpretation and financial modeling
• Support department training needs, including content development as necessary
• Ensure optimization of work processes to meet modeling needs of the standard Commercial formulary offerings to achieve department goals
• Monitor Commercial Formulary Solutions mailbox and respond to formulary related inquiries from cross-functional areas such as Sales & Account Management, Pharma Contracting, and others
• Create and deliver internal and external presentations for account team trainings, consultant and client meetings as needed
• Serve as subject matter expert on standard Commercial formulary offerings and serve as point of contact for clinical questions from internal team members, as well as cross-functional partners
• Support operational tasks for updating/maintaining standard Commercial formularies as needed
• Track and interpret the impact of future industry dynamics and market events including drug patent and pipeline landscape, regulatory activity and new product offerings
• Assist with marketplace consultative formulary support model, including content development, training and benchmark reporting analysis and interpretation
  
  

Qualifications

• PharmD; advanced degree or managed care residency a plus
• Current active U.S. Pharmacist License
• 1-3 years of pharmacy/PBM/Managed Care/healthcare related experience
• Formulary management/development experience preferred
• Exchange/Marketplace formulary management experienced preferred
• Excellent verbal and written communication skills
• Detail Oriented, Organizational and Analytical skills
• Excellent PC skills – including Excel, PowerPoint and MS Access, experience with databases preferred
• Financial or analytical modeling experience preferred
• Familiarity with pharmaceutical rebate contracts a plus
• Proven ability to work in a fast paced – ever changing environment
• Excellent relationship building and cross-functional skills
• Ability to travel approximately 10%
  
  

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: 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.