Job Description
Description of Position: - The Product Management Advisor will focus on managing Regulated Markets Capabilities. This position will ensure their capabilities are compliant with the Center for Medicare and Medicaid Services (CMS) regulations, lead implementation of enhancements, provide subject matter expertise to internal/external stakeholders, deliver presentations in account team/client forums, and ensure metrics and performance guarantees are met. This position will also support leading cross-functional initiatives that may be unrelated to the capabilities they own.
Position Details: - Be the recognized Subject Matter Expert and product advocate with all cross-functional areas of the organization
- Understand and ensure compliance to CMS guidance and regulations
- Influence account teams, clients, and external industry workgroups (NCPDP/PCMA)
- Support the product development life cycle leveraging agile methodology, partnering with Business and Technical Product Owners to communicate, document, and prioritize enhancements
- Develop and deliver product related training to clients and internal resources
- Analyze trends, develop, and implement recommendations to ensure client needs, compliance metrics, and/or internal support is met
- Ensure internal/external policies and procedures are documented, maintained, and followed
- Responsible for business documentation of compliance actions for routine guidance, execution of routine monitoring, and communication of client impacts
- Responsible for project scope, project plan, tracking project deliverables, and communicating project status
- Appropriately interact with account teams and clients
- Support internal/external audits as the subject matter expert for your capabilities
- Understand and use system tools to research issues and concerns
- Ability to see and apply business needs outside of one's own work area
- Cross-train and support other team initiatives where appropriate
Qualifications: - Bachelor's degree in related field or 3+ years relevant experience in managing products and leading projects in Medicare
- Familiarity with pharmacy adjudication and other PBM operations
- Experience in managing capabilities in Medicare and Medicaid preferred
- Strong strategic, analytical, problem solving, and project management skills required
- Familiarity in reviewing and interpreting complex guidance and regulations
- Excellent presentation skills and experience presenting
- Effective communication with internal and external individuals in various functional areas and at various levels of management
- Strong learning skills and ability to adapt to changing environment
- Advanced MS Excel, MS Access, and SQL skills are highly desirable
- Familiarity with industry standards organizations, preferably NCPDP and PCMA
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:
[email protected] for support. Do not email
[email protected] 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.
Job Tags
Permanent employment, Local area, Work from home,