Pbm Contracting Jobs (NOW HIRING)

This job will be filled by a candidate proximal to any Cigna/Evernorth corporate/multifunction office location.

Looking for a talented, confident individual with extensive PBM pricing expertise, an ability to drive change, grow their career, and a competitive desire to win business for our Health Plan clients. The Express Scripts Health Plan Growth Team is dedicated to partnering with our Health Plans to Win, Retain, and Grow pharmacy lives in their markets by being change agents and eliminating hurdles to ensure maximization of the PBM benefit offering, to grow their business and offer cutting edge pharmacy pricing arrangements to the plans they serve.

The Health Plan Growth Senior Advisor is a vital part of a team tasked with building all aspects of employer group pricing strategy for our Health Plan partners. The Senior Advisor will be a key leader serving as a PBM pricing expert for our health plan clients at a variety of organizational levels, including within the C-Suite. This role requires constant surveillance and rapid understanding of pricing trends in the employer space, as well as the broader landscape including legislative impacts, new market entrants and the evolution of legacy PBMs. The Senior Advisor will work closely with various internal teams such as Underwriting, Actuary, Operations and Legal to build and oversee complex pricing arrangements at the employer group level for a wide variety of clients.

If you want a growth opportunity and have what it takes to thoughtfully engage with clients, go deep on strategy, and develop novel pricing analytic and data tools, this role is for you.

ESSENTIAL FUNCTIONS

PBM Pricing Consultation

• Serve as PBM Pricing strategy expert for health plan clients, specifically focused in the ASO-Commercial space, interacting regularly with client leadership, as well as all levels of our internal organization

• Provide ongoing consultation in the following areas to our Health Plan clients:

  • New business pricing strategy

  • Existing client retention strategies and best practices

  • Consultant feedback loops and interaction roadmaps

  • Competitive intelligence, including evaluation of market dynamics

  • Pricing optics & bid analysis

  • PBM Contracting and RFP response best practice approaches

  • Various ongoing training activities with our clients

• Being a thought leader within the Health Plan Growth team, empowering our broader team of with a variety of strategic pricing insights

• A willingness to proactively engage with internal and external Underwriting, Sales, Operations and Finance partners to ensure strategic alignment and maximization of financial performance

• Ability to understand new PBM products, programs and legislative impacts quickly, and confidently explain the value, risk or opportunity to all stakeholders

QUALIFICATIONS

• 7+ years of PBM Pricing/Underwriting or Consulting experience at a reputable firm required

• 2+ years of client-facing experience, specifically in communication of complex financial analysis required

• Intimate knowledge of PBM industry dynamics, including broker/consultant strategies, market trends and headwinds, competitive intelligence, and coalitions, among others

• Strong presentation skills with an ability to articulate complex challenges in digestible terms, often to those with limited background in pharmacy pricing

• Comfortability in making key decisions with limited or ambiguous information and fast turnarounds

• Ability to think creatively to develop novel solutions to nuanced, complex problems

• Excellent verbal and written communication skills

• Detail oriented and organized, specifically regarding record keeping and note taking

• Proficiency Excel and PowerPoint, with a familiarity of various BI tools such as SQL and bi query

• History of demonstrating analytical rigor and problem-solving complex business cases

• Intense focus on client service and retention results

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 126,300 - 210,500 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.

At The Cigna Group, 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), 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, click here.

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.