[Hiring] Clinical Program Manager @Cigna Healthcare

Role Description

The Clinical Program Manager, Custom Implementation & Operations Support Services, leads Clinical Program Advisors and analysts supporting clinical program operations, custom client implementations, specialty programs, analyst services, and operational process improvements. This leader partners across clinical, implementation, product, technology, business, and Global Service Partners to translate requirements into accurate, timely, and sustainable operational solutions.

The role provides strategic and day-to-day leadership across custom client support, specialty program implementation, operational governance, data quality, process optimization, and ongoing pharmacy benefit and clinical configuration activities.

• Lead, coach, and develop clinical operations analysts and support resources.
• Oversee Clinical Operations Support Services, Specialty, Analyst Support Services, and Custom Support Services activities.
• Manage operational support for specialty programs, Pathwell, preventive programs, and other high-maintenance clinical initiatives.
• Lead the development of new operational processes for products and projects, establish sustainable maintenance models, and transition ongoing ownership to the appropriate operational teams.
• Partner with matrix stakeholders to gather requirements, assess operational impacts, and develop implementation approaches.
• Drive continuous improvement by identifying and leveraging automation and AI solutions to enhance team efficiency, data quality, workflow optimization, and operational scalability.
• Oversee and support Rx Configuration PBAB requests responsible for exception review, consultation, risk and feasibility assessment.
• Ensure accurate and timely execution of custom client requests, utilization management setups, drug list maintenance, and operational support services.
• Develop and maintain standard operating procedures, job aids, governance processes, and team documentation.
• Manage issue resolution, escalations, risk identification, and corrective action plans.
• Collaborate with technology, product, implementation, and operational partners to support new products, enhancements, and strategic initiatives.
• Support audit readiness, quality reviews, compliance activities, and operational controls.
• Monitor operational performance, service levels, capacity, and workload distribution.
• Lead cross-functional projects and organizational initiatives.
• Identify staffing, training, and development needs while building team capabilities and reducing key-person dependencies.
• Foster a culture of collaboration, accountability, adaptability, innovation, and continuous improvement.

Qualifications

• Pharmacy degree (BSPharm or PharmD) and an active pharmacist license in good standing.
• Five or more years of healthcare, pharmacy benefit management, clinical operations, or related experience.
• Relevant experience supporting custom client programs and solutions within pharmacy benefit management or clinical operations.
• Strong understanding of existing high-level-of-effort products and the operational processes required to maintain them.
• Two or more years of leadership or people-management experience.
• Demonstrated ability to lead operational teams in a highly matrixed environment.
• Strong project management, organizational, analytical, and problem-solving skills.
• Excellent verbal and written communication skills.
• Ability to manage multiple priorities and competing deadlines.
• Ability to influence stakeholders across business, operational, and technical organizations.
• Proficiency with Microsoft Office, including Excel and PowerPoint.

Requirements

• Experience in pharmacy benefit management, formulary management, utilization management, or clinical configuration.
• Experience supporting specialty pharmacy programs and custom client implementations.
• Knowledge of DCRS, CRS, FRS, Polaris, FIT, or related clinical configuration systems.
• Experience working with offshore or geographically distributed teams.
• Pharmacy, healthcare operations, or clinical program management background.

Benefits

• Comprehensive range of health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
• 401(k) plan.
• Company paid life insurance.
• Tuition reimbursement.
• A minimum of 18 days of paid time off per year.
• Paid holidays and leaves of absence.
• Annual salary range of 106,000 - 176,600 USD, depending on relevant factors, including experience and geographic location.
• Eligibility to participate in an annual bonus plan.

Company Description

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers, and patients. Join us in driving growth and improving lives.