Pharmacy Network Advisor (Centene) - Express Scripts - Hybrid - The Cigna Group
Morristown, NJ
About the Job
POSITION SUMMARY:
The Pharmacy Network Advisor is responsible for initiating maintenance and strategy solutions for all Centene lines of business, including Medicaid, Medicare, and Healthcare Marketplace/Exchange. Responsible for the planning, internal coordination, maintenance, and communication of pharmacy network activities and performance for line of business initiatives while maintaining key client relationships. Utilize technology, tools, processes and resources to anticipate and exceed client needs and expectations. Collaborate with internal business partners on client activity, expectations, and service needs.
ESSENTIAL FUNCTIONS:
+ Manage day to day client relationships through comprehensive knowledge of client's Network contractual and regulatory requirements.
+ Daily interaction with clients, consultants and producers providing preventative consultation, analysis and issue resolution associated with core services.
+ Responsible for timely and accurate management and execution of all client Network requests, including Network changes, error corrections, new setups and escalated issues.
+ Lead client resolution/escalation of client network issues as well as custom technology projects or strategies.
+ Support ongoing collaborative efforts with external partners and their consultants to conduct off-site meetings and recurring webcasts as appropriate.
+ Champion internal advocacy for client service. Member experience.
+ Support Risk Management for client performance guarantees.
IDEAL CANDIDATES WILL HAVE A COMBINATION OF THE FOLLOWING:
+ Bachelor's degree in related field or 8+ years of relative account management experience
+ Experience working in the regulated markets space
+ Excellent PC skills including Microsoft Office and Internet experience
+ Excellent verbal and written communication and presentation skills
+ Strong analytical and problem-solving skills
+ Strong focus on client satisfaction and client retention results
+ Demonstrated ability managing projects, utilizing proven project management processes
+ Ability to work cross-functionally to proactively communicate and to resolve issues with the highest sense of urgency
+ Ability to travel overnight up to 10%
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 94,700 - 157,900 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 Group .
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._
The Pharmacy Network Advisor is responsible for initiating maintenance and strategy solutions for all Centene lines of business, including Medicaid, Medicare, and Healthcare Marketplace/Exchange. Responsible for the planning, internal coordination, maintenance, and communication of pharmacy network activities and performance for line of business initiatives while maintaining key client relationships. Utilize technology, tools, processes and resources to anticipate and exceed client needs and expectations. Collaborate with internal business partners on client activity, expectations, and service needs.
ESSENTIAL FUNCTIONS:
+ Manage day to day client relationships through comprehensive knowledge of client's Network contractual and regulatory requirements.
+ Daily interaction with clients, consultants and producers providing preventative consultation, analysis and issue resolution associated with core services.
+ Responsible for timely and accurate management and execution of all client Network requests, including Network changes, error corrections, new setups and escalated issues.
+ Lead client resolution/escalation of client network issues as well as custom technology projects or strategies.
+ Support ongoing collaborative efforts with external partners and their consultants to conduct off-site meetings and recurring webcasts as appropriate.
+ Champion internal advocacy for client service. Member experience.
+ Support Risk Management for client performance guarantees.
IDEAL CANDIDATES WILL HAVE A COMBINATION OF THE FOLLOWING:
+ Bachelor's degree in related field or 8+ years of relative account management experience
+ Experience working in the regulated markets space
+ Excellent PC skills including Microsoft Office and Internet experience
+ Excellent verbal and written communication and presentation skills
+ Strong analytical and problem-solving skills
+ Strong focus on client satisfaction and client retention results
+ Demonstrated ability managing projects, utilizing proven project management processes
+ Ability to work cross-functionally to proactively communicate and to resolve issues with the highest sense of urgency
+ Ability to travel overnight up to 10%
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 94,700 - 157,900 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 Group .
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._
Source : The Cigna Group
