Senior Advisor, Pharmacy UM Strategy – Operations
The Cigna Group
full-time
Posted on:
Location Type: Hybrid
Location: St. Louis • Connecticut • Montana • United States
Visit company websiteExplore more
Job Level
About the role
- Lead and/or support high-visibility business projects impacting CHC drug UM operations
- Serve as an SME on UM systems and operational workflows
- Investigate complex escalations by validating true root cause
- Analyze and interpret large datasets (claims, benefit files, UM outcomes)
- Translate business strategy and compliance or contract requirements into clear operational requirements
- Present solution options with risks, benefits, and tradeoffs
- Support AHIP-related drug benefit and UM initiatives
- Drive communication in a highly matrixed environment
Requirements
- Bachelor’s degree preferred or 10+ years of relevant drug prior authorization experience
- Extensive knowledge of pharmacy and medical benefit UM operations and claims processing
- Strong analytical skills with experience working with large datasets
- Proven ability to lead complex initiatives and influence across matrixed teams
- Clear, concise communication skills with the ability to present to senior leadership.
Benefits
- Health insurance
- Retirement plans
- Paid time off
- Flexible work arrangements
- Professional development
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
data analysisclaims processingroot cause analysisoperational workflowsbusiness strategy translationcompliance requirements interpretationrisk assessmentbenefit analysisdrug prior authorizationUM outcomes analysis
Soft Skills
leadershipcommunicationanalytical thinkinginfluencepresentation skillsproblem-solvingcollaborationstrategic thinkingconcisenessmatrixed environment navigation