Job description

This role is work from home, but MUST be filled in eastern standard time or central standard time!!

Clinical Pharmacist (Cigna) – Drug/Biologic Utilization Management

Role Summary:
The Clinical Pharmacist supports the execution of Medicare Advantage clinical programs for Cigna. The Clinical Pharmacist assists with the development of Drugs/Biologics Part B initiatives that ensure appropriate utilization. Our goal is to manage Drug/Biologic utilization while maintaining and enhancing our relationships with medical providers and Cigna customers.

Essential Duties and Responsibilities:
Reviews and completes coverage requests for Drugs/Biologics from medical providers according to applicable clinical criteria and regulatory compliance requirements.
Implements utilization management strategy through therapeutic alternatives.
Provides guidance to intake representatives on processing coverage requests.
Coordinates cases with other clinical teams that support Medicare advantage clinical programs.
Completes assigned projects related to Medicare advantage clinical programs.
Provides information to medical providers, including but not limited to coverage criteria and Medicare Part B benefits.
Assists in the development of reports for clinical program performance.
Develops Drug/Biologic specific coverage authorization forms and denial rationales based on coverage criteria and Medicare Part B benefit.
Other duties as assigned by management.

Qualifications:
Pharmacy Degree (Pharm. D) or equivalent
Licensed Pharmacist required
2+ years practicing Pharmacy experience with strong clinical skills
2+ years of direct Medicare coverage review/utilization management experience preferred
Pharmacy Residency or Board Certification preferred (i.e. Board Certified, BCPS)
Knowledge of Microsoft Office Suite Word and Excel software and the ability to quickly learn proprietary systems
Ability to adapt to changing environments and processes
Strong organization and planning skills
Team oriented with strong verbal and written communication skills

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 104,600 - 174,300 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 .

About Cigna
Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you’ll enjoy meaningful career experiences that enrich people’s lives. What difference will you make?

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.

Cigna 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.

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