Program Management Advisor - Evernorth Health Services - Hybrid
Benefit Driven Rebate Optimization works cross functionally with a variety of business partners to manage client rebate eligibility for our full service and externally adjudicated clients.
Our Mission is to perform timely and accurate review of drug rebate eligibility based on the interpretation of applicable clinical drug policies and clients' benefit coverage against the corresponding pharmaceutical manufacturer contract requirements.
This role is integral to ensuring proper rebate invoicing set up to drive the best outcomes for all parties involved.
Ideal candidate will have a combination of:
* HS Diploma, required; Bachelor's Degree, preferred
* 2+ years related pharmacy benefits experience
* Excellent PC skills including Microsoft Office with a high degree of proficiency in Access and Excel required.
Familiarity with SQL would be considered a strong plus.
* Excellent problem solving and communication skills required.
Must be able to work under pressure and perform continual follow up in a timely manner in order to meet tight deadlines.
* This is a hybrid role and will likely require the ability to work in-person.
Duties and Responsibilities:
* Interprets rebate requirements contained within manufacturer rebate agreements to determine client rebate eligibility through clinical rules and criteria
* Possesses the knowledge and understanding of manufacturer contracts to effectively present any and all changes impacting rebate eligibility, displaying mastery of low and medium complexity contracts, while requiring assistance for high complexity contracts
* Develop knowledge of Formulary Rebate Processing systems to provide consultative support for contract set up.
* Mentor other analysts to support department training needs
* Owns at least one Benefit Driven Rebate Optimization processes and/or procedures, serving as mentor for execution.
* Identifies and recommends process improvements for Benefit Driven Rebate Optimization processes
* Provides professional support for Benefit Driven Rebate Optimization assignments and/or projects.
* Other duties as deemed essential by business to support rebates optimization processes
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 lac...
- Rate: Not Specified
- Location: St. Louis, US-MO
- Type: Permanent
- Industry: Finance
- Recruiter: Cigna
- Contact: Recruiter Name
- Email: to view click here
- Reference: 25006761
- Posted: 2025-06-07 10:06:02 -
- View all Jobs from Cigna
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