Clinical Program Director - Cigna Healthcare - Hybrid (Multiple Locations)

This is a hybrid position (3 days per week in-office + 2 days work at home).

The incumbent candidate can be based out of any US Cigna Healthcare office.
This position is a Hybrid role where the Cigna policy requires office alignment but is not restricted to locations that are identified in this posting.

RESPONSIBILITIES:


* Responsible for the commercial formulary change process evaluating pharmacy and medical drug strategy opportunities and formulary product enhancements to drive pharmacy affordability to Cigna Health Plan clients


* Responsible for the development of complex utilization management strategies and drug utilization review programs to enhance formulary strategies and improve clinical outcomes in alignment with the clinical determination of the Pharmacy and Therapeutics Committee


* Ensures the clinical integrity of the Health Plan pharmacy offering


* Partners with Health Plan and Health Services Product teams and Supply Chain to evaluate and deploy available Health Services solutions that meet Health Plan clinical and affordability goals.


* Develops differentiated prescription drug benefit affordability capabilities that meet the unique needs of the buying groups and funding types within the Health Plan book of business.


* Responsible for ensuring downstream implementation processes are efficient and support the continuous development business strategies


* Partner with Federal/State government affairs in health plan drug-related issues to foster a favorable regulatory environment


* Ensure regulatory compliance by reviewing new state mandates and updating internal processes to support adherence


* Provides clinical and contextual insights to partners within the Health Plan finance, underwriting, and risk-bearing products to ensure that emerging therapeutics and revisions to the US drug supply are accurately reflected in financial projections (trend, underwriting, and pricing).


* Partner with the Health Plan Medical organization to support discussions with professional societies about complex and/or controversial formulary changes where engagement with external organizations is needed


* Provides clinical support to the Integrated Health Plan pharmacy client-facing teams, responding to RFP requests, and evaluating client customization requests


* Responsible for training/onboarding and ongoing development of new team members on formulary processes and policies


* Builds, develops and inspires a high performing pharmacy team and culture:
+ Creates a sense of purpose/meaning for the team that aligns with Cigna's value and mission.
+ Supports and promotes appropriate team alignment and process improvement work.
+ Provides coaching and development to teams, in particular, direct reports for succession planning and overall career growth.
+ Fosters an effective work environment and ensures employees receive appropriate communication, recog...