Clinical Program Advisor - Express Scripts - Remote (Clinical Operations)

About the position

The Clinical Program Advisor at The Cigna Group plays a crucial role in providing expert counsel and advice on significant Clinical Program Management matters. This position requires coordination across various organizations and focuses on delivering thought leadership and technical expertise. The advisor serves as a key representative for the company, educating stakeholders to enhance care coordination and improve customer satisfaction. Additionally, the role involves advising the sales organization on product and industry knowledge to positively influence cost, quality, and customer satisfaction.

Responsibilities
? Serve as business owner for client work involving Medicare operational and implementation benefits changes, as well as other non-Medicare lines of business.
,
? Understand client's existing clinical benefit and business philosophy to help avoid unnecessary clarifications.
,
? Accurately capture and document clinical benefit requirements in collaboration with business stakeholders.
,
? Provide excellent customer service and act as a trusted client advisor.
,
? Work with internal partners to ensure all implications of requested clinical benefit requirements are vetted, understood, and communicated as necessary.
,
? Provide operational Subject Matter Expertise (SME) to Clinical Account Executives/Implementation Manager (CAE/IPM's), Ben Ops, Clinical Application Teams (DCRS, FRS, CRS, Criteria), Product Owners.
,
? Manage and track all requests to ensure timelines are met.
,
? Develop a deep understanding of claims adjudication system and associated clinical applications.
,
? Lead the development, preparation, and presentation of project plans including execution and delivery for each client assigned.
,
? Participate and contribute in formal and informal training programs and professional development activities.

Requirements
? Current U.S. Pharmacist License, Pharm.D.
,
? Minimum of 3 years licensure experience preferred in managed care or with previous PBM experience.
,
? Knowledge of PBM industry/Managed care/Value Based healthcare industry is desired.

Nice-to-haves
? Ability to multitask and communicate effectively.
,
? Strong understanding of Microsoft Office, particularly Excel and Access.
,
? Advanced problem-solving skills and the ability to work collaboratively with other departments.

Benefits
? Comprehensive health-related benefits including medical, vision, and dental.
,
? Well-being and behavioral health programs.
,
? 401(k) with company match.
,
? Company paid life insurance.
,
? Tuition reimbursement.
,
? Minimum of 18 days of paid time off per year and paid holidays.

Apply Job!

For more such jobs please click here!