Washington, District of Columbia, USA
21 hours ago
Clinical Policy Managing Director

Job Duties and Responsibilities

Represent ESI and Evicore regarding clinical and PBM policy, serving as a leader externally with policymakers on issues relevant to the external environment to testify at the State and Federal levels on issues of clinical and business impact, i.e., utilization management, interoperability/automation, and clinical affairs spaces, to achieve policymaker and patient impact.  Must have excellence in distilling difficult concepts to understandable and impactful level.Develop multi-year strategic plan template to adapt for planning efforts a strategy, tactical plan on impacting policymaker views so the business may achieve growth, revenue and earnings goals across the PBM and clinical divisions holistically.  Examples:Must be able to specifically deliver an ambitious plan that demonstrates meaningful and measureable progress to ensure external environment understands options, evidence, benefits of our enterprise PBM and clinical spaces. Must be able to discuss digital engagement as a scalable medical affairs solution to deliver across large patient populations.Must be able to come up with innovative approaches related to new models of care for the government, identifying evidence needs of patients, providers, and payers.Develop messaging for policymakers to increase understanding regarding our enterprise activities, championing innovation, patient outcomes and addressing issues evolving in the ecosystem. Examples:Must be able to clearly articulate the PBM and overall utilization management value proposition.Must be able to message and discuss clinical decision processes on how we look at optimal care and be able to quantify the impact of clinical affairs activities to reduce suboptimal care.Must be able to establish and clearly articulate our enterprise strategy regarding medical engagement that impacts on care delivery.Must be able to discuss automation of medical processes.Engage with stakeholders and drive collaboration models with provider groups, including national physician and hospital organizations and patient advocacy groups to achieve our strategic goals.Use business and financial acumen to gather and analyze data and develop insights to drive appropriate conclusions about the strategic and financial attractiveness of concepts/initiatives.Collaborate with internal and external business development contacts to facilitate cross-functional initiatives.Manage tight deadlines for multiple competing priorities, scope, and converging opinions to solution in a timely manner. 

Qualifications

Physician thought leader with substantive health policy background.Proven track record for success in a matrixed environment.Demonstrated leadership related to challenging problems with examples of implementing innovative analytic and environmental solutions.10+ years experience working with multi-disciplinary teams.Ability to work independently with minimal guidance.Extremely strong verbal/written communication and leadership skills.Previous work with state and/or federal policymakers.Ability to efficiently develop insights from analytics and assess attractiveness of various concepts.


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 278,600 - 464,400 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 Group.

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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.

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