Job Description

Product Management Senior Advisor – Medicare Solutions, Express Scripts

Description of Position

• The Product Management Senior Advisor provides leadership and strategic direction for capabilities and new product development within Regulated Markets. This position will ensure their capabilities are compliant with the Center for Medicare and Medicaid Services (CMS) regulations, lead implementation of enhancements, provide subject matter expertise to internal/external stakeholders, deliver presentations in account team/client forums, and ensure metrics and performance guarantees are met. This position will also support leading cross-functional initiatives that may be unrelated to the capabilities they own.

Position Details

• Serve as the Regulated Markets business owner for specific capabilities
• Lead large initiatives for Regulated Markets to develop new capabilities and/or or enhance existing functionality
• Review and provide direction on CMS regulations to maintain compliance, partnering with Legal and Compliance
• Communicate strategic recommendations for supported capabilities and execute tactics to deliver the strategic vision
• Be the Subject Matter Expert and capability advocate with all cross-functional areas of the organization
• Influence account teams, clients, and external industry workgroups (NCPDP/PCMA)
• Develop and deliver training to clients and internal resources
• Oversee the product development life cycle leveraging agile methodology, partnering with Business and Technical Product Owners to communicate, document, and prioritize enhancements
• Analyze trends, develop, and implement recommendations to ensure client needs, compliance metrics, and/or internal support is met
• Ensure internal/external policies and procedures are documented, maintained, and followed
• Responsible for business documentation of compliance actions for routine guidance, execution of routine monitoring, and communication of client impacts
• Responsible for project scope, project plan, tracking project deliverables, and communicating project status
• Support internal/external audits as the subject matter expert for your capabilities
• Ability to see and apply business needs outside of one’s own work area
• Serve as a mentor and support the development of junior team members
• Cross-train and support other team initiatives where appropriate

Qualifications

• Bachelor’s degree in related field or 5+ years relevant experience
• Familiarity with pharmacy adjudication and other PBM operations
• Experience in managing capabilities in Medicare and Medicaid preferred
• Preferred, but not required to have knowledge in one or more of the following Medicare Capabilities: Inflation Reduction Act (IRA) or Part D Vaccines
• Strong strategic, analytical, problem solving, and project management skills required
• Skilled in review and interpretation of complex guidance and regulations
• Excellent presentation skills and experience presenting
• Effective communication with internal and external individuals in various functional areas and at various levels of management
• Strong learning skills and ability to adapt to changing environment
• Advanced MS Excel, MS Access, and SQL skills are highly desirable
• Familiarity with industry standards organizations, preferably NCPDP and PCMA

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 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.

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