Cigna Pharmacy Sr. Clinical Consultant (Clinical Account Manager) in St Louis, Missouri
This Pharmacy Clinical Account Manager role provides clinical account management support for a large national health system with approximately 238,000 customers. In this role, the Clinical Account Manager will expand their relationships broadly within Cigna, Cigna Pharmacy Management and the National Account Medical Team to meet the sophisticated needs of the health system.
- Works in tandem with the Cigna Medical account management organization to support the clinical needs of the heath system.
- Develops and maintains relationships with internal and health system partners to advance the Cigna mission.
- Delivers quality clinical support to Cigna, the health system and its customers.
- Supports the Pharmacy Benefit Management (PBM) strategy and Cigna's retention activities.
- Serves as a pharmacy benefit subject matter expert to the health system.
- Analyzes pharmacy and medical benefit utilization to determine potential solutions to manage costs and promote quality of care.
- Interprets and translates pharmacy coverage rules based on Cigna policies and evidence-based medicine guidelines.
- Develops clinical strategies and provides clinical consulting with respect to formulary management, drug utilization management, and drug information.
- Develops a clear understanding of the health system’s goals and objectives form a clinical perspective.
- Supports the health system’s open enrollment meetings to communicate benefit changes
- Supports the health system’s pharmacy directors and responds to inquiries
Supports the health system from a clinical perspective, including:
Communicates Cigna’s evidence-based clinical coverage policies through application and understanding of drug information evaluation and analysis techniques.
- Effectively partners with the health system’s clinical program management team and medical director to assure clinical coverage policies meet business needs and strategic goals.
Manages the health system’s Pharmacy and Therapeutics (P&T) Committee.
Presents formulary, therapeutic class strategy and coverage policy recommendations developed by Cigna to the health system at a quarterly Pharmacy and Therapeutics Committee.
- Manages the P&T Committee membership, organization of quarterly meetings, communicate the committee decisions, and implement the final decisions.
- Works with other team members to have coverage policies and formulary decisions implemented, deployed to internet sites and changes communicated to the organization.
- Organizes interim drug coverage review process, interim criteria development, and new drug code analysis.
- Assists in clinical claim edit review, development, and maintenance.
- Assists in clinical communications for drug pipeline, FDA approvals, and other clinical information topics, including adverse safety event information from FDA.
- Licensed Pharmacist required
- Bachelor’s Degree in Pharmacy from an accredited school of pharmacy required, advanced clinical degree (PharmD or clinically-oriented Master’s Degree preferred)
- 3-5 years of direct client clinical/account management experience within a Pharmacy Benefit Management (PBM), or related industry, required
- Experience managing and presenting at P&T committee meetings for a health plan, health system or Pharmacy Benefit Manager (PBM) required.
- PBM/Managed Care experience in clinical administration of prescription benefits required
- PBM, Specialty Pharmacy and Healthcare knowledge and experience required.
- Strong interpersonal and organizational skills
- Ability to manage and ensure completion of multiple complex projects and shift priorities quickly while staying in tune with product upgrades and developments.
- Processes oriented with a forward thinking ability to present solutions and identify efficiencies
- Project management skills, high attention to detail, as well as the ability to work in a fast-paced environment and meet tight deadlines
- Ability to travel up to 50% of the time
Primary Location: St Louis-Missouri
Other Locations: United States-Tennessee-Memphis, United States-Kentucky, United States-Indiana, United States-Illinois-Chicago, United States-Tennessee-Nashville
Employee Status: Individual Contributor
Job Type: Full-time
Job Level: Day Job
Travel: Yes, 50 % of the Time
Job Posting: Oct 17, 2018, 5:05:48 PM
Qualified applicants will be considered for employment without regard to age, race, color, religion, national origin, sex, sexual orientation, gender identity, disability, veteran status. Need an accommodation? Email: SeeYourself@cigna.com