See all roles

Clinical Program Advisor - Express Scripts - Remote (Clinical Operations)

Work from home Full-time role Hiring

About the position The Clinical Program Advisor at The Cigna Group plays a crucial role in providing expert counsel and advice on significant Clinical Program Management matters. This position requires coordination across various organizations and focuses on delivering thought leadership and technical expertise. The advisor serves as a key representative for the company, educating stakeholders to enhance care coordination and improve customer satisfaction. Additionally, the role involves advising the sales organization on product and industry knowledge to positively influence cost, quality, and customer satisfaction. Responsibilities • Serve as business owner for client work involving Medicare operational and implementation benefits changes, as well as other non-Medicare lines of business. , • Understand client's existing clinical benefit and business philosophy to help avoid unnecessary clarifications. , • Accurately capture and document clinical benefit requirements in collaboration with business stakeholders. , • Provide excellent customer service and act as a trusted client advisor. , • Work with internal partners to ensure all implications of requested clinical benefit requirements are vetted, understood, and communicated as necessary. , • Provide operational Subject Matter Expertise (SME) to Clinical Account Executives/Implementation Manager (CAE/IPM's), Ben Ops, Clinical Application Teams (DCRS, FRS, CRS, Criteria), Product Owners. , • Manage and track all requests to ensure timelines are met. , • Develop a deep understanding of claims adjudication system and associated clinical applications. , • Lead the development, preparation, and presentation of project plans including execution and delivery for each client assigned. , • Participate and contribute in formal and informal training programs and professional development activities. Requirements • Current U.S. Pharmacist License, Pharm.D. , • Minimum of 3 years licensure experience preferred in managed care or with previous PBM experience. , • Knowledge of PBM industry/Managed care/Value Based healthcare industry is desired. Nice-to-haves • Ability to multitask and communicate effectively. , • Strong understanding of Microsoft Office, particularly Excel and Access. , • Advanced problem-solving skills and the ability to work collaboratively with other departments. Benefits • Comprehensive health-related benefits including medical, vision, and dental. , • Well-being and behavioral health programs. , • 401(k) with company match. , • Company paid life insurance. , • Tuition reimbursement. , • Minimum of 18 days of paid time off per year and paid holidays. Apply Job!

You might like

REMOTE Senior Machine Learning Engineer - ML, AI, Data Science

Work from home Full-time role

Online Training Support Assistant - Work remote/ no experience needed

Work from home Full-time role

Underwriting/Operations Assistant - Transportation (Atlanta, GA or Bala Cynwyd, PA)

Work from home Full-time role

Medical Insurance/Denials Specialist -Work from home (must reside in Texas)

Work from home Full-time role

Nurse Practitioner HouseCalls, Traveler in FL and US Virgin Islands

Work from home Full-time role

HCA Healthcare is hiring: Inpatient Coding Editor in Corpus Christi

Work from home Full-time role

Experienced Solar Sales Closers - No Door Knocking, Work Remotely!

Work from home Full-time role

Insurance Verification Specialist – NMA (Neuromonitoring Associates) – Dallas, TX

Work from home Full-time role

Remote - Licensed Practical Nurse (LPN) - Massachusetts Licensure Required

Work from home Full-time role

Beech Valley Solutions – Junior Financial Analyst FP&A – USA

Work from home Full-time role

IT Recruiter (Junior) ID59492

Work from home Full-time role

Walgreens Data Entry Remote Jobs (Wfh) $27/Hour mysmartpros

Work from home Full-time role

Support and Administrators for SharePoint, OneDrive, Intune, Defender- (remote from Europe)

Work from home Full-time role

Experienced Remote Data Entry Specialist – Aviation Data Management and Quality Assurance

Work from home Full-time role

Experienced Home-Based Data Entry Specialist – Customer Service and Data Processing

Work from home Full-time role

Population Health Lead - Remote in Dublin, OH

Work from home Full-time role

Miami Food / Product Photographer – Small Brand, Clean & Premium Style

Work from home Full-time role

Tech Lead, Web Core Product & Chrome Extension - Las Vegas, NV, USA

Work from home Full-time role

Part Time Sales - Paid Weekly - Work from Home

Work from home Full-time role

Experienced Enterprise Customer Base Account Executive – Driving Strategic Growth and Customer Satisfaction at arenaflex

Work from home Full-time role