Evernorth

The job profile for this position is Product Management Director, which is a Band 5 Management Career Track Role.

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We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply!

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Job Description: Director for Regulated Markets – CDAG/ODAG

Excited to grow your career?

We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply!

Our people make all the difference in our success.

Role Summary:

The Director of Regulated Markets is responsible for Coverage Review and Determinations for Medicare Part B and Part D, Medicaid, Marketplace or Healthcare Reform (HCR) and Commercial. This position will have business and product ownership, including strategic direction, project support of technical requirements to ensure ongoing compliance, Center for Medicare and Medicaid (CMS) Audit support and end-to-end ownership of Coverage Review letters, including Commercial.

The role will be responsible for ensuring CDAG/ODAG requirements meet legal and compliance requirements as well as the needs of clients and business partners. This position will be responsible for a team of individuals that lead multiple projects and initiatives that reach across the organization as well as ongoing day-to-day product management. This role will require strategic planning, managing stakeholder priorities, overseeing delivery, execution and oversight of daily operations. This individual will work with cross-functional partners and leaders to build trusted relationships that enable business objectives to be met. The ideal candidate will have a broad based knowledge of Regulated Markets, a strategic mindset, the ability to influence and drive change and the capability to create and drive new processes. The successful leader will exemplify Cigna’s high-performance culture and have the ability to operate in a sometimes ambiguous and high-paced environment. A successful candidate must be comfortable in an environment of dynamic change and evolution.

In its current capacity, the Director will be expected to manage a team of 8 individuals (3 direct reports; 5 indirect).

Essential Functions:

• Analyze existing processes/systems to ensure legal/compliance requirements are met as well as business and client needs
• Responsible for area performance, inclusive of key KPIs, minimizing and mitigating business risks
• Coordinate with cross-functional partners to understand, analyze and ultimately implement improvements, increase operational efficiency and/or address gaps in CDAG/ODAG
• Provide influence, subject matter expertise and strategic support on new product launches within the organization that affects CDAG/ODAG
• Builds constructive and effective relationships across the company
• Implement applicable regulations with vague/ambiguous requirements in a dynamic regulatory environment
• Optimize core business processes, introduce innovative ideas, and foster operational excellence across the organization
• Effectively communicate strategies and deliverables with clients, account teams and leadership
• Understands business impacts to the PBM as well as clients and member experience when making recommendations for viable solutions
• Anticipate, mitigate, and manage risk within team scope
• Be the senior point for issue escalation and resolution for issues involving CDAG/ODAG
• Maintain relevant tools, reporting, documentation, processes, guides, and training so that they are available and implemented across the enterprise.
• 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
• Ability to see things differently, and act in a nimble manner to address requirements
• Lead, coach, and develop individuals to maintain a high performing team

Qualifications:

• Bachelor’s degree required; MBA or PharmD preferred
• 10+ years relevant experience
• A result-focused executor, who brings discipline, drive, and accountability to ensure delivery of key initiatives
• Detailed knowledge and expertise of the regulated markets and the PBM industry
• Adept at working with senior leaders and developing key relationships
• Ability to work cross functionally with multiple departments to gain consensus and move projects and initiatives forward
• Experience in attracting top talent, building and developing effective teams
• Able to synthesize regulations and present them to clients and account teams in an effective manner
• Demonstrated ability to set priorities including, but not limited to time management and organizational skills
• Proven track record of delivering high quality results
• Successful results leveraging data and analytics to gain actionable insights that enable product/solution development and business growth
• Experience in managing and implementing large scale initiatives preferred
• Strong strategic, analytical, problem solving, and project management skills required
• Able to create a sense of purpose and meaning for the team that generates followership beyond their own personality and engages others to advance the company’s greater purpose
• Able to overcome resistance to ensure the appropriate outcome
• Naturally connects and builds strong relationships with others, demonstrating strong emotional intelligence and an ability to communicate clearly and persuasively

Required Competencies/Behaviors:

• Strong in strategy development, communication and execution
• 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.

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.

Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.