Operations Director - Hybrid - Express Scripts

We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions.  If you think the open position you see is right for you, we encourage you to apply!  Our people make all the difference in our success.

As the Express Scripts Inc. (ESI) Health Plans Division (HPD) Operation Director (OD), you will provide operational leadership, expertise, and oversight to some of the most complex arrangements and customized clients.    This rewarding position holds significant responsibility as the operations leader to our front line Account Managers.

This client facing OD will report to a Sr. Operation Director within HPD and is responsible for all day-to-day activity of his/her assigned HPD client portfolio and account teams while ensuring that all Service Level Agreements (SLA) meet or exceed their contractual obligations; thereby driving client satisfaction and retention. Additionally, this role will be for one who can establish and maintain solid working relationships with leaders from both internal departments as well as external clients, vendors and/or consultants.

The ideal candidate will have a superior working knowledge and understanding of the pharmacy benefit industry/processes including, but not limited, to those within Commercial, Health Care Exchanges and Medicare Part-D lines of business.  Such responsibilities include:

• Self-sufficient experienced organizational leader who can collaborate with all levels and can tailor the message with the right level of detail as appropriate, strong executive presence
• Uses good judgement and proper channels on when to escalate, leveraging colleagues and leadership
• Represent the organization in providing solutions to difficult technical issues associated with complex setup and similar arrangements
• Owns overall client account relationship including escalation support
• Sponsor standard and more complex projects that require development by ensuring client requirements are clearly defined, thoroughly captured and implemented to the commitment
• Owns operational support for RFPs
• Lead or participate in internal meetings to drive resolution
• Supports new product and business implementations
• Leads HPD key initiatives aimed at improving the client experience, business model, employee well-being, margin or other processes
• Champions SOP and establishes best practices as needed

Minimum Qualifications:

• 10+ years of relevant experience
• Bachelor Degree strongly preferred
• Experience with leading multiple teams and mentoring individuals to success
• Excellent verbal/written communication and presentation skills
• Proficient with MS Office suite, Skype and Webex
• Exceptional data analytics capability and problem solving skills
• Demonstrated ability in managing high visibility projects, often independently or through Sr. leadership
• Resourceful with a proven ability to exercise good judgement in problem solving
• Able to manage multiple tasks simultaneously; shift priority quickly as needed
• Takes free initiative to mitigate a found gap and socializes the same for enterprise awareness
• Strategic thinking; weighs the potential risks or conflict associated with executing change and has awareness to how it may impact downstream or interdependent systems
• Ability to comprehend the business need while also anticipating questions, and addressing those proactively back to the client and/or leadership
• Advanced MS Excel; able to create pivots, write formulas, leverage macros and/or write VB
• Knowledge of CMS and HHS requirements and regulations associated with Med-d and ACA
• Industry knowledge of NCPDP D.0, PAL, Plan Finder, PDE, AGL, and how intakes from MSP, FDB and the like play an integral role in our business
• Technically savvy with SFTP (Secure File Transmission Protocol), file layouts, claim adjudication, billing and invoicing
• Participates and/or leads willingly on internal work groups
• Possesses a keen awareness to client temperature and proactively creates mitigation plans
• Takes powerful initiative to develop action plans to resolve areas of opportunity
• Proactive follow-up and understands when to raise risks/concerns
• Develops robust reporting to capture milestones, successes as well as opportunities
• Ability to travel overnight up to 15-20% as needed, mostly with ample notice

Primary Work Location(S):

• Remote/Virtual
• Morris Plains, NJ
• St. Louis, MO

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.For this position, we anticipate offering an annual salary of 119,000 - 198,400 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.

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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com 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.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.