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Clinical Staff Pharmacist
The Cigna GroupUtilization management pharmacist at Cigna overseeing clinical drug policies and decisions. Collaborating with multidisciplinary teams to ensure effective medication coverage and management.
About the role
Key responsibilities & impact- Utilization management pharmacists are responsible for reviewing each plans 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
Requirements
What you’ll need- 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
Benefits
Comp & perks- medical
- vision
- dental
- well-being and behavioral health programs
- 401(k)
- company paid life insurance
- tuition reimbursement
- minimum of 18 days of paid time off per year
- paid holidays
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical pharmacyutilization managementclinical reviewsprior authorizationcritical thinkingqueue system managementspecialty pharmacy
Soft Skills
collaborationcustomer centricitydecision makingoversight
Certifications
Licensed Pharmacist