Senior Clinical Pharmacist -Evernorth - Hybrid (Drug Policy)

The Senior Clinical Pharmacist, Cigna Health Care Drug policy pharmacist is responsible for developing coverage policies and clinical criteria for drugs and biologics supporting the health plan drug coverage under medical and pharmacy benefits for new therapies, new indications, and annual review for traditional and specialty pharmaceuticals.

This pharmacist supports timely evaluation and response to drug information requests and serves as clinical content expert to health plan oversight committees and other quality and compliance groups.

This role will work cross-functionally with health plan pharmacy management, implementation teams, and business leads for as the clinical expert in development and update of coverage policies and clinical criteria supporting formulary and utilization management programs.

When appropriate, pharmacists will represent Cigna Health Care drug policy team in support of internal or external service partners as needed based are areas of clinical focus and job responsibilities

Essential Functions


* Develop and update clinical coverage policies and criteria through application and understanding of drug information evaluation and analysis techniques for employer group commercial plans


* Apply knowledge of benefit plan language and business required customizations to standard Pharmacy and Therapeutics Committee policies


* Perform pharmaceutical compendia, society specialty guideline, and clinical literature search to respond to individual drug inquiries and for drafting custom policies and clinical criteria


* Presents coverage policies developed or revised to clinical review meetings


* Assures that clinical coverage policy documents clearly communicated for external health care professional web site, communication report, and internal policy tracking


* Assure that coverage policies implemented in operational systems


* Serves as clinical subject matter expert on assigned policies/ clinical topic areas


* Collaborate with Medical Management/ Formulary and UM teams supporting clinically congruent solutions for benefit, product, compliance needs of our internal and external customers.


* Assists Coverage Policy Unit team in equitable distribution of administrative and information tracking spreadsheets

Qualifications


* Pharm D Degree preferred


* 3+ years general pharmacy experience preferred


* Current Pharmacist License.


* Excellent writing and communication skillsrequired


* Standard Microsoft Office set, advanced research skills.


* Ability to analyze data and make recommendations, synthesize data and clinical information through research.


* Working knowledge of pharmacy practice issues and challenges.

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 ant...