"Please note this role is open to Cigna Group retirees only."

This position will support creation of a clinical data elements library. The data elements library will be derived from our existing, standard prior authorization policies.

JOB SUMMARY:

Clinical Specialists are responsible for strategic development, creation, and maintenance of standard clinical products and services within their assigned product areas. Clinical Specialists clinically frame new solutions to ensure alignment with existing guidance and consistency across products and services throughout the organization. They also guide and manage the clinical enhancement of existing products, working closely with cross-functional partners to ensure final solutions are clinically sound, defensible, and aligned with organizational standards. In addition, Clinical specialists work collaboratively with product managers, and our sales and account teams to ensure that our clinical recommendations and program offerings are not only clinically appropriate but meet the business needs of our internal and external customers.

ESSENTIAL FUNCTIONS:

• The primary function of this role is to develop and maintain drug lists related to state mandates. Drive recommendations through necessary legal, regulatory and clinical governing bodies.
• Facilitate cross-functional collaboration with regulated markets, legal, clinical and account management clinical leadership
• Clinically frame new solutions that are congruent with existing guidance to ensure products & services across the organization are clinically aligned.
• Frame, guide, and manage the clinical enhancement of existing products with cross-functional partners to ensure the final solution is clinically sound and defendable.
• Translate clinical treatment guidelines, medical literature and prescribing information into population health & safety alerts for providers, pharmacists, and members.
• Other activities as needed including meeting with pharmaceutical manufacturers to gather clinical information; review, prepare, and support clinical content for other clinical programs.
• Must be team-oriented and possess a proactive and optimistic style which reflects a strong commitment to clinical services and company goals.

MINIMUM QUALIFICATIONS:

• BS in Pharmacy or Doctor of Pharmacy (Pharm.D.) degree required
• Relevant managed care experience
• Active Pharmacist License required
• Completion of a pharmacy residency preferred
• Board of Pharmaceutical Specialties certification preferred
• Strong written and verbal presentation skills, with the ability to communicate complex information clearly
• Ability to collaborate with cross functional partners
• Ability to apply clinical information to population management strategies
• Strong computer skills

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.