Director of Formulary Modeling - Express Scripts - Hybrid

JOB SUMMARY:

The primary role of this position is to support Centene's formulary modeling process and to carry out the initiatives identified by leadership. Positioned as a strategic leader in the organization for all aspects of Centene formulary rebate modeling and client rebate support. An emphasis will be placed on strategically evaluating financial models to drive optimum formulary value. Work cross-functionally with Pharma Contracting, Sales & Account Management and Finance partners in analyzing formulary financials and positioning of formularies to make strategic recommendations on formulary changes. Accountable for leading the formulary consultants in driving the strategy for Centene formularies to provide aligned value to the client, patients and Express Scripts. Work cross functionally across the entire organization to proactively communicate and evaluate new formulary strategies and maintain/enhance existing formulary strategies, with a focus on innovation. Represent formulary modeling internally and externally, as needed. Positioned to manage and lead formulary conversations directly with Centene.

ESSENTIAL FUNCTIONS:

• Provide consultation through rebate contract interpretation and strategic opportunity identification
• Lead and mentor Senior Advisors, Advisors, and Lead Analysts to help support department training needs
• Meet with Formulary Decision Makers and Leadership to cultivate relationships and help guide their formulary strategy
• Evaluate client data, create scenarios, and provide expert formulary modeling guidance in alignment with department strategic objectives to drive rebate value
• Collaborate and strategize with Cross Functional Partners (Sales & Account Management, Pharma Contracting, Underwriting) to create strategies based on formulary, utilization management, rebate offerings, and modeling options.
• Lead formulary modeling strategy and represent team during client meetings, conferences, etc.
• Review potential utilization management programs under evaluation to ensure that all modeling and requirements of these programs are accurately represented and in alignment with Pharmaceutical rebate contracts
• Analyze and track the financial impact of formulary changes to both the client and Express Scripts
• Create and deliver presentations for executive level client formulary strategy and/or consulting meetings
• Lead interdepartmental team calls as required to discuss rebate pertinent topics as directed by Senior Director.
• Effectively document and communicate custom formulary analysis projects (i.e., model maintenance and QC)
• Ensures optimization of work processes for formulary modeling strategies and achievement of department goals
• Build/maintain positive client working relationship
• Meet or exceed client formulary modeling support expectations

IDEAL CANDIDATES WILL HAVE A COMBINATION OF THE FOLLOWING:

• Bachelor's degree in related field (data analytics, finance, economics, computer science, clinical - Rph, etc.)
• Master's degree or Pharm.D. (preferred; but not required)
• Leadership experience preferred
• 10 to 12 years of relevant experience with 4 years of significant formulary management/development experience preferred
• Advanced problem solving skills with the ability to work cross-functionally to generate results
• Embraces creativity to set a vision for partners in successful resolution of pressing issues
• Track record of developing new and innovative strategies to address business needs
• Demonstrated ability to evaluate financial pharmaceutical data and drive action to identify and create additional value
• Strong business, financial, analytical, and organizational skills required.
• Knowledge of PBM or managed care/healthcare industry
• Excellent customer service, technical, and communication skills required
• Excellent PC skills including Microsoft Office Suite, internet navigation, and data manipulation & querying

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: [email protected] for support. Do not email [email protected] 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.