Clinical Pharmacist - Formulary (Healthcare Exchange)

Clinical Pharmacist – Clinical Support and Development IFP (Individual and Family Plan) - Remote

This position is responsible for the clinical actions following release of new/existing drug products, evaluating and managing drug utilization review, and assisting with the development of formulary strategies with clinical program senior advisors.

The strategic framework will discover or establish the following utilization management:

• Evaluate success of current UM programs

• Evaluate, review, and improve current clinical programs

Responsibilities:

• Review current utilization management strategies to ensure strategies promote affordability and customer experience

• Organize and coordinate with a team of matrix partners and subject matter experts to assess opportunities to create non-condition based clinical programs

• Examine egregious medications/products and coordinate with clinical program senior advisors to provide appropriate clinical recommendations to minimize IFP plan costs

• Provide clinical subject matter expertise to the release and placement of new medications on the IFP formularies

• Provide support to the clinical program senior advisors to enhance clinical affordability and total health outcomes

• Provide support for the required annual IFP formulary submissions to CMS and the states

• Support for the implementation of new IFP formularies and maintenance of current IFP formularies

• Provide support to address new or updated regulatory requirements for IFP formularies

• Provide support for medical drug strategy initiatives  

• Communicate to matrix partners IFP's clinical strategy to ensure consistent execution of class strategy

• Other responsibilities as assigned

Qualifications:

• Bachelor’s Degree in Pharmacy required; PharmD preferred. Must have a license in good standing in state of residence.

• 2+ years experience working in a managed care, health plan, Pharmacy Benefit Management (PBM) organization, or formulary management required

• Solid understanding of evidence-based medicine, interpreting clinical literature, and standards of care required

• Results driven with proven communication, interpersonal and collaboration skills working in a cross-functional and matrixed environment required

• Experience developing end to end Pharmacy Clinical Programs preferred

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.

For this position, we anticipate offering an annual salary of 111,900 - 186,500 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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