Clinical Program Senior Advisor - Hybrid (Program Strategy)

This is a Hybrid position (3 days per week in-office + 2 days work at home). The incumbent candidate can be based out of any US Cigna Healthcare office and is not restricted to locations that are listed in this posting.

Role Summary:

The Clinical Program Senior Advisor manages and supports the overall vision, goals, and objectives of clinical programs and products offered to Cigna Pharmacy clients and customers.

This position is focused on developing and executing comprehensive pharmaceutical strategies across the plan that focuses on the quadruple aim: improving affordability, health outcomes, customer experience, and positively impacting provider satisfaction.  Responsible for ensuring that programs are clinically sound and successful in meeting operational excellence criteria and affordability targets. This role supports the execution of new development or enhancements to existing programs from conceptualization through implementation. Programs encompass activities that include condition-specific medication management programs and customer-/provider-targeted services intended to improve the experience of clinical care and/or quality of drug benefits administration.

Program development work will emphasize whole health management in the integrated Cigna framework, aligning with multiple areas to create coordinated care management and focus on total cost of care and pharmacy affordability. The position works closely with matrix partners across the medical organization, PBM partners, Contracting, Pharmacy pricing/finance, Clinical Operations, Coverage Policy Unit, Pharmacy and Medical client facing partners, Sales, Pharmacy product, Analytics, Compliance, Legal, and Specialty Pharmacy as well as external partners.

Responsibilities:

• Proactively identifies, analyzes, and monitors emerging clinical trends, practices and solutions; recommends programs that materially contribute to the growth and affordability of Cigna Pharmacy Health Plan business
• Provides clinical oversight and support for the conceptualization, design, program development, implementation, operations and reporting for new and expanded services
• Organize and lead teams of matrix partners and subject matter experts to assess opportunities to deliver results consistent with condition-specific goals, total cost of care and total health outcomes
• Collaborate with data analyst partners to define and develop analytic needs and methodology to deliver clinical program solutions and track success against the affordability plan
• Evaluate the success of current clinical program to determine areas of enhancement
• Participates in internal and external meetings regarding the launch of new clinical programs, maintenance of existing clinical programs and cross-functional initiatives that support pharmacy affordability and total cost of care
• Provide education and training for matrix partners (Sales, Product, Case Management and Coaching, Medical Management) to communicate clinical strategy and solutions to improve pharmacy affordability, total cost of care, and total health outcomes.
• Coordinate the execution of these actions with partners in Supply Chain, Medical Management, Contracting, Drug Policy, Specialty Pharmacy, Provider Network, Community pharmacies, collaborative care organizations and other areas that can impact results
• Provides clinical support for the development, enhancement, and evaluation of the Pharmacy Product portfolio.
• Works with Chief Pharmacy Officer and Clinical Program Director to develop and track clinical activity priorities that meet team and department goals

Qualifications:

• Licensed Pharmacist required
• PharmD preferred; advanced degree a plus
• Minimum 3 years of clinical experience in a managed care pharmacy setting required
• Demonstrated ability to work in a highly matrixed environment
• Demonstrated ability to think/act strategically from a program value perspective and influence key leaders and matrix partners
• Demonstrated understanding of analytical methods to monitor and measure cost and quality aspects of drug benefit required
• Combination of clinical expertise and business acumen, with experience in driving affordability through clinical outcomes consistently across multiple segments; including how Cigna can effectively commercialize our current and future clinical services in the context of enterprise strategic priorities
• Ability to communicate complex clinical concepts and insights to leaders and partners at all levels of the organization in a relevant and actionable manner
• Experience in strategic planning and developing end to end Pharmacy Clinical Programs required
• Effective leadership, prioritization and management in a dynamic environm