Pharma Rebate Analytics Lead Analyst supporting the BDRO-Benefit Driven Rebate Optimization team OVERVIEW
This position may be responsible for review and interpretation of current clinical rules impacting rebate eligible drugs. Review and interpret client benefit structure and its impact on rebate eligibility as outlined in manufacturer rebate agreements. Continuously review changes, additions and deletions to client clinical benefits and manufacturer contracts for impact to eligibility. Update rebate systems appropriately based on performance of review. Appropriately analyze proper timelines and update rebate eligibility systems accordingly. ESSENTIAL FUNCTIONS Interprets rebate requirements contained within manufacturer rebate agreements to determine client rebate eligibility through clinical rules and criteria Update clients' clinical rules decisions according to contract changes presented Monitor upcoming client clinical changes and update clinical rule decisions and validating invoicing as required Possesses the knowledge and understanding of manufacturer contracts to effectively present any and all changes impacting rebate eligibility, displaying mastery of less complex contracts, while requiring assistance for medium to high complexity contracts Develop knowledge of Formulary Rebate Processing systems to provide consultative support for contract set up. Provides professional support for Benefit Driven Rebate Optimization assignments and/or projects. Other duties as deemed essential by business to support rebates optimization process QUALIFICATIONS Bachelor's degree in Business or related field preferred. HS Diploma required At least 2-4 years related experience, preferably in a Pharmacy/PBM environment Strong proficiency in MS Excel, OneNote and MS Office Products Ability to work independently with some management oversight Ability to work cross-functionally to resolve issues and collect reports Ability to handle analysis from issue identification to proposal of potential solutions Demonstrated initiative with commitment and ability to work under pressure and meet tight deadlines Knowledge of PBM or Healthcare industry preferred Strong business, organizational and communication skills This is hybrid role and would require the ability to work in person in our St. Louis, MO office
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.
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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.
