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 skills required + 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 anticipate offering an annual salary of 125,700 - 209,500 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. We want you to be healthy, balanced, and feel secure. That’s why 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) with company match, 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, visit Life at Cigna Group . About The Cigna Group Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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 require reasonable accommodation in completing the online application process, please email:_ _SeeYourself@cigna.com_ _for support. Do not email_ _SeeYourself@cigna.com_ _for an update on your application or to provide your resume as you will not receive a response.__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._...Assist patients with prescribed occupational/physical therapies. In collaboration with others, carry out an individualized, comprehensive, and patient centered Plan of Care in accordance with current applicable Federal, State and local standards, guidelines and regulations...
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