Job Description
Overview: B enefit Driven Rebate Optimization works cross functionally with a variety of business partners to manage client rebate eligibility for our full service and externally adjudicated clients. Our Mission is to perform timely and accurate review of drug rebate eligibility based on the interpretation of applicable clinical drug policies and clients' benefit coverage against the corresponding pharmaceutical manufacturer contract requirements. This role is integral to ensuring proper rebate invoicing set up to drive the best outcomes for all parties involved.
Responsibilities: - Work cross-functionally with Pharma Contracting, Formulary Consulting, Clinical Account Executives and Pharma Invoicing to assure appropriate interpretation of clinical rules and benefit set up impacts on rebated drug products
- Provide clinical support in documentation of appropriate policies and procedures for analysis and appropriate determination of client eligibility for rebate enhancement and exclusion options.
- Provides clinical/professional support for Benefit Driven Rebate Optimization assignments and/or projects.
- Provide consultative clinical support in the interpretation of rebate requirements contained within manufacturer rebate agreements.
- Provide consultative support determining rebate impacts due to considered changes to formulary and benefits on rebate eligible products
- Other duties as deemed essential by business to support rebates optimization process.
Qualifications: - 2-4 years of benefit analysis in PBM industry. CAE or CPM experience a major plus
- Excellent PC skills including Microsoft Office with a high degree of proficiency in Access and Excel required. Familiarity with SQL would be considered a strong plus.
- Excellent problem solving and communication skills required. Must be able to work under pressure and perform continual follow up in a timely manner in order to meet tight deadlines.
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 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.
Job Tags
Permanent employment, Contract work, Local area,