Director Provider Contracting Credentialing Jobs

This position assists the VP of Pharma Strategy and Contracting with setting the strategy and ensures the effective execution of ESI Pharma rebate contracts. This position has responsibility for up to half of the pharmaceutical manufacturers for our Medicare, Commercial Government, LTC, and Managed Medicaid books of business as well as working with Ascent Health Services on our overall Commercial rebate strategy.

ESSENTIAL FUNCTIONS

• Responsibilities for this role include, but are not limited to, any and all of the following areas:

• Assisting the VP of Pharma Strategy and Contracting in determining manufacturer, product class, and drug strategies and executing on these strategies

• Collaborate with Ascent Health Services on product class strategies and approaches with pharmaceutical manufacturers for our Commercial book of business that creates "win-win" opportunities for ESI and Ascent.

• Manage Pharma relationships and develop Strategic partnerships with targeted Pharma companies across multiple internal departments within ESI's Supply Chain.

• Interact with the formulary modeling team (Commercial and Medicare) to develop and create product category strategies and pharma manufacturer rebate requests to maximize value and deliver cost savings.

• Consult and provide insight with any and all Cigna Health Plan and large Custom Client formulary and rebate requests or market strategies.

• Assist the Account Directors in finalizing all manufacturer rebate agreements and matrices to ensure accuracy, signature, and implementation for invoicing.

• Support Sales and Account Management on RFPs and/or presentations or discussions with clients.

• Represent our department and provide guidance and formulary strategies for Custom Clients and assist the Formulary Consultants on any rebate requests.

• Interact with cross-functional management teams including clinical, account management, operations, finance, and specialty business development as needed.

QUALIFICATIONS

• 8+ years of relevant experience.

• Registered Pharmacist (RPh or PharmD) and/or MBA a plus, but not required

• Strong financial acumen with an understanding of supply chain dynamics.

• Strong interpersonal skills with the ability to collaborate well with both internal and external teams and stakeholders.

• Exceptional written and verbal communication skills and presentation skills.

• Solid negotiation skills with the ability to influence and persuade while balancing the needs of the organization and external partners.

• Adaptable with the ability to navigate complex dynamics and ambiguity. Ability to effectively cope with setbacks.

• Honest, direct and transparent communication style.

• Self-starter who can work well independently as well as with the broader team.

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 need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

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.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.