[Hiring] Clinical Staff Pharmacist @The Cigna Group

Role Description

Utilization management pharmacists are responsible for reviewing each plan's policy to determine if coverage can be granted for a medication. Provide clinical support and oversight for all utilization management (UM) activities. Responsible for finalizing all denials of clinical prior authorization requests.

• Supports the Coverage Review Department (CRD) as a clinical resource for drug therapy questions
• Applies critical thinking to achieve proper clinical decisions when performing clinical reviews
• Utilizes multiple systems and other clinical resources to achieve proper decisions in Utilization Management reviews
• Works and maneuvers within a queue system that prioritizes clinical reviews
• Makes clinical decisions quickly and at times decides and acts with limited information
• Works and collaborates with a multi-disciplinary clinical team to provide a customer-centric experience

Qualifications

• Licensed Pharmacist required
• Bachelor’s Degree in Pharmacy required; PharmD preferred
• 5+ years of clinical pharmacy experience
• Proficient technical skills utilizing Microsoft Office applications required
• Utilization Management Experience Preferred, but not required
• Experience with Specialty Pharmacy/Pharmaceuticals preferred
• 2+ years lead/supervisor or retail pharmacy experience preferred

Requirements

• 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.

Benefits

• Hourly rate of 55 - 91 USD / hourly, depending on relevant factors, including experience and geographic location
• Eligible to participate in an annual bonus plan
• 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 and paid holidays

Company Description

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.