POSITION SUMMARY
Responsible for managing all aspects of pharmacy contractual guarantees. Analyst will conduct routine analysis on guarantee performance and make pharmacy pricing recommendations to management in order to meet the guarantees.
Responsible for coordinating, conducting, and documenting financial analysis projects or financial reporting. Conducts or participates in financial analysis projects and/or reporting. Presents results and recommendations to management. Manage rate updates, including loading and maintain rates in adjudication system. Responsible for working cross functionally with Supply Chain leadership, Analytics and Network teams to implement pricing strategies. Perform analysis of claims data for key corporate strategic projects. ESSENTIAL FUNCTIONS Managing pharmacy pricing in order to meet contractual guarantees Reviewing pharmacy contracts and ensuring that all guarantees are accounted for Monitoring, adjusting pricing and reporting of pharmacy guarantee performance Enter and maintain provider rates in adjudication system Implementation of pricing strategies to meet all Provider guarantees Development and implementation of modeling tools and analysis in support of provider contracting strategies including performance measurement and analysis Cross Functional support of internal business partners through ad hoc projects Analysis of claims data related to assessment of strategic corporate initiatives and projects
Location: This is a hybrid position and requires the ability to work in person, in our St. Louis, MO office, 3 days a week QUALIFICATIONS Bachelor's degree strongly desired (preferably in mathematics, business, accounting or finance) At least 1-3 years of business analysis, modeling, pricing or data management experience preferred Experience with data warehouse and/or coding experience preferred Experience with all MS Office applications, Visual Basic, and SQL Analytical, highly organized, able to work with little supervision, motivated to successfully meet deadlines, attention to detail and ability to multi-task Excellent Communication skills, oral and written Capability to prepare and present concepts and proposals to all levels of management Knowledge of PBM or Healthcare industry preferred
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.
If you require reasonable accommodation in completing the online application process, please email: for support. Do not email for an update on your application or to provide your resume as you will not receive a response.
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.
