Drug Plan Management Specialist

7 days ago

Mississauga, Ontario, Canada The Cigna Group Full time

As new drugs come on the market and drug costs continue to rise, Drug Plan Management looks for new ways to manage drugs plans and provide alternatives to traditional plan designs.

The Drug Plan Management (DPM) Specialist is responsible for the creation and setup of new drug plans as well as the maintenance of existing drug plans and formularies.

As a member of the Clinical department, the DPM Specialist maintains the quality assurance program for drug plan management processes, collaborates with the Clinical Services and Drug Database teams to provide recommendations on new drugs to customers for their drug plan and responds to drug plan inquiries received by Customer Services and other departments.


ESSENTIAL FUNCTIONS:


Reviews, analyzes, develops and maintains drug plans for new group installations and contract modifications by identifying drugs to be covered to meet the groups requirements.

Collaborates with internal departments (i.e. Customer Services, Information Systems, Drug Database, and Clinical Services) and customers to complete requests within standard turnaround times
Completes the process documentation for new drug plans. Ensures that customers receive completed and accurate documentation within expected timelines
Maintains drug plans and their components for customers by following documented processes to ensure that decisions for drug additions/removals meet group plan contract requirements
Assists in the maintenance of standard drug plan designs as a result of revisions such as legislation/industry standard changes, or in group transfers to Express Scripts Canada
Performs peer-review to ensure accuracy and quality of work as per plan design specifications Provides support to Customer Services and other internal teams to respond to queries regarding plan design specifications
Participates in client meetings to understand requirements and provide recommendations to meet client requirements
Participates in educational and training programs, both internally and externally.
Regularly attends internal Drug Evaluation Committee (DEC) meetings to provide perspective for new drugs currently reviewed

QUALIFICATIONS:

2+ years working experience as a Pharmacy Technician within a hospital and or community setting
Certified Pharmacy Technician (CCPHT) designation is preferred
Experience in pharmacy benefit management or insurance is an asset
Strong working knowledge of provincial drug plans and range of products offered within a pharmacy
Proficient with Microsoft Office Suite of tools (Word, Excel, Outlook)
Demonstrated familiarity with drug nomenclature and pharmacy practice in Canada
Proven critical thinking and analytics skills
Excellent interpersonal skills with the ability to communicate effectively and tactfully

Strong interpersonal skills:
team player and ability to work cross-functionally with other departments
Effective time management, organizational and prioritizing skills
Bilingualism (French & English) is an asset

Note:
Internal Posting will close on September 11, 2023.

Express Scripts Canada is a Cigna company
Express Scripts Canada is a subsidiary of Express Scripts, a Cigna company

Cigna Corporation (NYSE:
CI) is a global health service company dedicated to improving the health, wellbeing and peace of mind of those we serve.

Cigna offers an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioural health, pharmacy, vision, supplemental benefits, and other related products.

About Express Scripts Canada
Express Scripts Canada is a leading health benefits manager and has been recognized as one of the most innovative. Our clients include Canada's leading insurers, third party administrators and governments. We work with these clients to develop industry-leading solutions to deliver superior healthcare in a cost-controlled environment.

We provide Active Pharmacy services to more than 7 million Canadian patients and adjudicate more than 100 million pharmacy, dental, and extended health claims annually.

Through our proprietary consumer intelligence, clinical expertise, and patients-first approach, we promote better health decisions for plan members, while managing and reducing drug benefit costs for plan sponsors.


We offer a competitive salary and benefits package, along with a positive work environment built on solid corporate values, integrity, mutual respect, collaboration, passion, service and alignment.

We are an equal opportunity employer that promotes a diverse, inclusive and accessible workplace.

By embracing diversity, we build a more effective organization that empowers our employees to be the best that they can be.


We are committed to creating a working environment that is barrier-free and we are prepared to provide accommodation for people with disabilities.

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