Help protect the integrity of Express Scripts' pharmacy networks and the experience we deliver to clients and members. In this role, you will solve complex compliance and operational challenges, strengthen provider oversight, and help teams improve how work gets done. You will partner across the business, use data and technology thoughtfully, and bring the judgment and curiosity of an ambitious and compassionate expert.
Responsibilities- Partner with contracted pharmacy providers and internal teams to research and resolve complex compliance and operational matters.
- Lead or contribute to cross-functional projects that design, test, and implement business applications, technology solutions, and process improvements.
- Analyze complex issues, identify risks and opportunities, and turn findings into clear, timely recommendations and solutions.
- Improve processes by simplifying work, automating workflows, and strengthening alignment across teams and partners.
- Monitor network provider compliance with applicable state and federal requirements, internal policies, and established procedures.
- Support client, internal, and other applicable audits by preparing information, coordinating responses, and addressing operational needs.
- Create, review, and maintain standard operating procedures, policies, training materials, and other process documentation.
- Share recommendations, concerns, and operational risks with the right stakeholders while building trusted cross-functional relationships.
- Promote operational excellence through continuous improvement, effective use of technology, and consistent execution.
Required Qualifications - 3+ years of experience in pharmacy benefit management, pharmacy networks, healthcare operations, compliance, or a related field.
- Strong analytical, critical-thinking, problem-solving, and decision-making skills, including the ability to translate complex research into practical recommendations.
- Ability to independently manage multiple priorities, deadlines, and deliverables in a fast-paced environment with changing or unclear needs.
- Clear written and verbal communication skills, with the ability to raise questions, recommendations, concerns, and risks across levels of the organization.
- Strong organization, time management, attention to detail, sound judgment, and the ability to know when to act independently, collaborate, or escalate.
- Advanced Microsoft Excel skills, including formulas, data analysis, and pivot tables, plus proficiency with PowerPoint, Word, Access, and related business applications.
Preferred Qualifications - Experience with regulatory requirements and industry standards related to accreditation, credentialing, delegation, or oversight.
- Experience improving processes, supporting audits, developing procedures or training, or implementing technology solutions in a regulated environment.
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 62,200 - 103,600 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.
At The Cigna Group, 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), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.
