ROLE SUMMARY:

The Senior Director of Regulated Markets Audit and Clinical Operations provides strategic direction, guidance and management for a team that is responsible for Regulated Markets clinical operations, audit readiness and coverage determination capabilities oversight. This role is responsible for driving line of business (Medicare, Medicaid and Healthcare Reform) clinical strategy, operations and execution working across organization to define and refine products and capabilities that will meet our client and member needs. The role will also have oversight and management of RM clinical capabilities that will provide clinical support across the RM team inclusive of transition capabilities, drug list maintenance, coverage determinations and RM clinical initiatives. The areas of functionality supported by this team are the primary focus of CMS Program Audit and ensuring that these areas continue to meet all requirements is critical to the success of our Medicare Part D clients.

The Senior Director will report directly to the Managing Director, Product Strategy.

In its current capacity, the Senior Director will be expected to manage three Directors directly, and twenty indirect reports.

ESSENTIAL FUNCTIONS:

• Directly and indirectly, lead team members responsible for the RM clinical operations scope.

• Responsible for area performance, inclusive of key KPIs, minimizing and mitigating business risks.

• Assist in developing and maintaining competitive market view on RM product offerings and work cross functionally to craft strategies to ensure market leadership position.

• Lead, coach, recruit, curate and directly manage the verticals focused on ensuring delivery against departments goals & objectives.

• Drives an active coaching and high-performance culture within the Regulated Markets team.

• Provide leadership to the team by removing barriers and handling potential roadblocks through partnership with cross-functional teams and swift business decisions.

• Ability to lead and participates in cross functional initiatives as assigned

• Effectively participates in, and contributes to, staff meetings, committees and departmental work groups to share best practices, improve processes, and/or other items relating to provider engagement

• Builds constructive and effective relationships across the company.

QUALIFICATIONS:

• Bachelor’s degree, Pharmacy Doctorate Preferred

• 10-14 years relevant experience

• A result-focused executor, who brings discipline, drive, and accountability to ensure delivery on plans for capturing market share

• Detailedknowledge and expertise of the regulated marketsand thePBM industry

• Adeptat working withsenior leadersand developing key relationships

• Ability towork crossfunctionally withmultipledepartmentstogainconsensusand move projectsandinitiativesforward

• An inspirational, compelling leader who is capable of communicating the vision to external and internal constituents; and commanding the respect and enthusiasm

• Experience in attracting top talent, building and developing effective teams.

• Demonstrated ability to set priorities including, but not limited to time management and organizational skills.

• Proven track record of delivering results of high quality.

REQUIRED COMPETENCIES/BEHAVIORS:

• Strong in strategy development, communication and execution

• Strong business and financial acumen

• Client centric / customer focused

• Ability to build strong relationships

• Ability to build and manage strong internal teams

• Demonstrate the ability to negotiate cross functionally to drive client issues to resolution

• Ability to manage work strategically, effectively anticipating/planning for client impact of internal and external influencers

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 168,400 - 280,600 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 and long term incentive 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 (https://jobs.cigna.com/us/en/life-careers) .

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.

Cigna 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.