Senior Director Utilization and Contracting Management (Hybrid)

Overall

Responsible for leading clinical strategy development and product management for pharmacy utilization management and the coordination of rebate contracting efforts to ensure alignment across formulary, utilization management, SafeGuard, and other trend solutions. 

Essential Functions:

• Ability to manage development and execution of clinical UM strategy.  This would include both the ongoing updates to existing UM solutions and the evolution of UM to both incorporate new technologies and meet the changing demands of both clients and regulators

• Ability to understand and ensure alignment with clinical guidance within our trend solutions and contracting efforts.  Meet with clinical leadership and SMEs to support efforts to update clinical guidance and its application to create solutions that provide financial savings with a clinical-first mindset

• Ability to understand and negotiate contracting language to protect formulary and trend solutions from unintended conflicts across commercial, Medicare, and product offerings that depend on those contracts.

• Support of negotiator teams to drive efficient communication of asks and the resulting internal stakeholder evaluation of newly obtained contracted rates and/or language

• Ability to collaborate and support PBM solutions and supply chain strategic initiatives

• Ability to work and influence cross-functional partners to achieve key initiatives and corporate goals

• Demonstrated initiative with commitment and ability to work under pressure and meet tight deadlines

• Ability to work cross functionally with finance to model opportunities and track the financial value of the programs

• Effectively communicate with clients, pharmaceutical manufacturers, and other external stakeholders/partners to support adoption of new solutions, demonstrate Evernorth expertise, and to promote the PBM’s ability to serve clients and patients

• Lead a team of multiple direct reports and their associated teams.  Responsible for the identification and development of talent within the team to ensure continuity and to support the growth of new leaders.  Ensure the team drives both the consistency and innovation necessary to accomplish the financial and outcome goals in support of Evernorth commitments

Qualifications:

• Bachelor’s degree or beyond in an applicable area of study, which could include business/product strategy, business development, pharmacy, or healthcare management

• 8+ years relevant experience

• Licensed pharmacist in good standing, if degree is Pharmacy

• Excellent verbal, presentation, and written communication skills required; proven leadership skills, team-orientation, a proactive management style and strong commitment to client service a must; ability to work on multiple tasks, prioritize, resolve complex issues, and have strong project management skills; ability to learn multiple internal reporting and analytic tools use advanced problem-solving skills; work independently, as well as collaboratively.

• Intellectual curiosity and strong professional judgement. Demonstrated ability for creative analysis and creative problem-solving.

• Strong financial acumen

• Ability to handle complex analysis, from issue identification to proposal to solution implementation.

• Demonstrated initiative with commitment and ability to work under pressure and meet tight deadlines.

• Strong relationship development capabilities with ability to work effectively with Senior Management.

• Strong detail orientation, organization, and management of multiple parallel projects with fluid timelines. 

• Strong ability to work independently and to lead diverse teams.

• Experienced people leader with a focus on facilitating a positive and inclusive team culture

• Knowledge of PBM industry/Managed care/ healthcare industry is desirable

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.

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.