Responsibilities :

• Manage clinical programs through their life cycle, including market strategy, product direction, clinical design, program outcomes, reporting, client satisfaction, and future innovative product development.

• Be the source of truth and subject matter expert for all stakeholders involved in the clinical product development and ongoing management.

• Contribute to the strategic direction for core standard clinical products and services, inclusive of criteria development, clinical rule design and program outcomes.

• Collaborate with cross-functional partnership– Technology, Knowledge Solutions (reporting), Operations, Marketing, Billing/Finance, Legal, Sales Enablement and Sales and Account Management teams.

• Provide internal and external presentations in support of Care Solution products and on complex clinical concepts.

• Maintain a strong work ethic, an exceptional level of integrity, a team mentality, and a collaborative attitude.

• Deliver outstanding communication skills in regard to creating strategic agendas, leading meetings, keeping stakeholders informed on key initiatives, and escalating significant matters to leadership.

Qualifications

• Licensed Clinician with license in good standing (Pharmacist, Nurse, Nurse Practitioner, Medical Doctor, Doctor of Osteopathy, or other applicable Clinicians);

• Relevant 5 or more years of work experience;

• Utilization management experience preferred;

• Proficiency in using Microsoft Office applications;

• Excellent verbal, presentation, and written communication skills required;

• Ability to work on multiple tasks, prioritize, resolve complex issues, and have strong project management skills;

• Ability to learn medical claim billing, clinical rule automation, reporting, and analytic tools;

• An analytical mindset with a focus on goals and how to measure them;

• Must proficiently work independently, as well as collaboratively;

• Basic financial analysis skills;

• Excellent customer service skills required;

• Clinical expertise and understanding of clinical arena/issues across all points of medical pharmaceuticals preferred;

• Experience with clinical informatics and EMR preferred

About the Department

The Care Solutions department is responsible for developing and managing programs and services that allow our customers deliver better health-related outcomes. As a member of the Care Solutions team, you’ll have frontline insight into how healthcare products are built, released to market, and managed to improve the care of millions of patients.

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.

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.