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Clinical Program Consultant

2 months ago

Bloomington, United States The Cigna Group Full time

Clinical Program Advisor Role

We are seeking a Clinical Program Advisor to provide expert insight and guidance on complex clinical rebate modeling assignments. As a key member of our team, you will collaborate with various stakeholders to deliver initiatives that positively impact cost, quality, and customer satisfaction. This role requires a deep understanding of clinical criteria and the ability to analyze data to drive strategic rebate pricing strategies. If you are a detail-oriented, analytical professional with a passion for healthcare, we want to hear from you.

Key Responsibilities

  • Perform in-depth drug level analysis for clients to inform rebate pricing strategies
  • Apply contracted rebate rates based on clinical criteria to ensure accurate pricing
  • Collaborate with underwriters to ensure alignment and effective communication
  • Conduct quality assurance reviews to ensure compliance and accuracy
  • Answer clinical queries from team members to provide expert guidance
  • Identify process improvement opportunities to enhance efficiency and effectiveness
  • Analyze data to support rebate pricing strategies and inform business decisions
  • Review health plan policies for rebate eligibility to ensure compliance
  • Partner with teams to understand client financial positions and develop tailored solutions
  • Provide expert modeling and guidance for clients to inform business decisions
  • Pitch strategic rebate optimization ideas to drive business growth
  • Present modeling results to leadership to inform business decisions
  • Evaluate the financial impact of formulary changes to inform business decisions
  • Work on special projects and presentations to drive business growth

Requirements

  • Bachelor's degree in pharmacy, Pharm.D. preferred
  • 2-4 years of relevant experience in clinical rebate modeling
  • Detail-oriented with strong analytical skills and ability to work in a dynamic environment
  • Proficient in Excel, PowerPoint, and MS Access
  • Financial modeling experience and ability to analyze data to drive business decisions
  • Excellent relationship-building skills and ability to thrive in a fast-paced environment
  • Occasional travel required to collaborate with stakeholders and clients