Benefit 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.
Ideal candidate will have a combination of:
HS Diploma, required; Bachelor's Degree, preferred
2+ years related pharmacy benefits experience
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.
This is a hybrid role and will likely require the ability to work in-person.
Duties and Responsibilities:
Interprets rebate requirements contained within manufacturer rebate agreements to determine client rebate eligibility through clinical rules and criteria
Possesses the knowledge and understanding of manufacturer contracts to effectively present any and all changes impacting rebate eligibility, displaying mastery of low and medium complexity contracts, while requiring assistance for high complexity contracts
Develop knowledge of Formulary Rebate Processing systems to provide consultative support for contract set up.
Mentor other analysts to support department training needs
Owns at least one Benefit Driven Rebate Optimization processes and/or procedures, serving as mentor for execution.
Identifies and recommends process improvements for Benefit Driven Rebate Optimization processes
Provides professional support for Benefit Driven Rebate Optimization assignments and/or projects.
Other duties as deemed essential by business to support rebates optimization processes
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.