Lead a team of Senior Advisors and Advisors responsible for the development and management of the Medicare Prescription Payment Plan (M3P) product. This individual will provide leadership and strategic direction to their team and to other Regulated Market resources responsible for the operational components of M3P. The ideal candidate will have experience in managing client facing products, broad-based knowledge of Regulated Markets/Pharmacy Benefit Manager (PBM) operations, experience leading people, a strategic mindset, and the ability to influence and drive change. This position will ensure compliance with the Center for Medicare and Medicaid Services (CMS) guidance/regulations regarding M3P, provide subject matter expertise to internal/external stakeholders, deliver presentations in account team/client forums, support existing and new client implementations, and ensure metrics and performance guarantees are met.
Key Responsibilities:
Lead a team of Senior Advisors and Advisors responsible for the M3P product and strategic direction.
Review and provide direction on CMS guidance/regulations to maintain M3P product compliance, partnering with Legal and Compliance
Support account teams and clients on all components of the M3P product
Collaborate closely with the Regulated Markets Team responsible for M3P operations as well as cross-functional teams like benefits, communications, finance, prescription drug event (PDE), and others to define requirements and ensure the product is functioning appropriately
Ensure client intent setup is accurate within multiple internal systems
Analyze market trends and competitive landscape to identify opportunities for product differentiation
Communicate strategic recommendations and execute tactics to deliver the strategic vision of the product, including selling of product to clients not currently contracted with Express Scripts
Oversee the product development life cycle leveraging agile methodology, partnering with Business and Technical Product Owners to communicate, document, and prioritize business needs
Influence account teams, clients, and external industry workgroups
Monitor product performance and customer feedback to drive continuous improvement
Responsible for business documentation of compliance actions for routine guidance, execution of routine monitoring, and communication of client impacts
Ensure internal/external policies and procedures are created, maintained, and followed
Develop and deliver training to clients and internal resources
Support internal/external audits as the subject matter expert
Understand and use system tools to research and resolve issues and concerns
Crosstrain and support other team initiatives where appropriate
Qualifications:
Bachelor's degree in a relevant field, such as Business Management, Healthcare Administration or Pharmacy
5+ years of experience in product management preferably in healthcare or pharmacy benefit management industry
Experience in managing and implementing large scale Medicare initiatives preferred
Strong strategic, analytical, problem solving, and project management skills required
Ability to think creatively and translate strategies into actions/requirements
Successful track record as a people manager and/or possesses clear aptitude as a leader
Excellent organizational agility skills with a strong understanding of business processes and operations to facilitate execution of initiatives
Skilled in review and interpretation of complex guidance and regulations
Ability to see and apply business needs outside of one's own work area
Excellent presentation skills and experience presenting complex information in an understandable way to various audiences
Effective communication skills with experience communicating with internal and external individuals in various functional areas and at various levels of management
Strong learning skills and ability to adapt quickly to a changing environment
Familiarity with industry standards organizations, preferably National Council for Prescription Drug Programs (NCPDP), Pharmaceutical Care Management Association (PCMA), and America's Health Insurance Plans (AHIP)
Advanced MS Excel, MS Access, and SQL skills are highly desirable
Willingness to travel occasionally for internal meetings, client meetings, or industry conferences
* * * This is a hybrid role that requires the ability to work in person three days per week. * * *
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: 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.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
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.
