Clinical Program Director - Cigna Healthcare - Hybrid (Multiple Locations)
About the position
The Clinical Program Director at Cigna Healthcare is responsible for overseeing the commercial formulary change process and developing complex utilization management strategies to enhance clinical outcomes and drive pharmacy affordability. This hybrid role requires collaboration with various teams to ensure the clinical integrity of the pharmacy offerings and compliance with regulatory standards. The position also involves training and developing a high-performing pharmacy team, aligning with Cigna's values and mission.
Responsibilities
?? Evaluate pharmacy and medical drug strategy opportunities and formulary product enhancements to drive pharmacy affordability.
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?? Develop complex utilization management strategies and drug utilization review programs to improve clinical outcomes.
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?? Ensure the clinical integrity of the Health Plan pharmacy offering.
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?? Partner with Health Plan and Health Services Product teams to deploy solutions that meet clinical and affordability goals.
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?? Develop differentiated prescription drug benefit affordability capabilities for various buying groups.
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?? Ensure efficient downstream implementation processes that support business strategies.
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?? Collaborate with government affairs on health plan drug-related issues to foster a favorable regulatory environment.
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?? Review new state mandates to ensure regulatory compliance and update internal processes accordingly.
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?? Provide clinical insights to finance, underwriting, and risk-bearing products for accurate financial projections.
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?? Support discussions with professional societies regarding complex formulary changes.
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?? Provide clinical support to pharmacy client-facing teams and evaluate client customization requests.
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?? Train and onboard new team members on formulary processes and policies.
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?? Build and inspire a high-performing pharmacy team and culture, promoting alignment and process improvement.
Requirements
?? Registered Pharmacist with active licensure in a US state or territory; advanced degree preferred.
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?? Previous experience in developing clinical programs related to Formulary and Utilization management.
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?? Minimum of 6 years experience in the healthcare industry, focusing on Pharmacy Health Plan or Pharmacy Benefit Management.
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?? Proven capabilities in strategic planning and large-scale project management.
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?? Demonstrated ability to think strategically and influence key leaders and matrix partners.
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?? Ability to work in a highly matrixed environment.
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?? Strong communication and facilitation skills with diverse stakeholders.
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