VP, PBS Technology

OVERVIEW:

Reporting directly to the SVP of Express Scripts and Care Management Technology, we are looking for a passionate, innovative, mission-based leader to guide our Technology organizations supporting the PBS Business. This leader will be responsible for product management, planning, engineering and platform strategy for the Evernorth Pharmacy Benefit Management (PBM) systems.

Working closely with Business, Operations, and Technology partners (Cigna and Evernorth), along with leveraging technology and a transformational skillset, this leader will provide strategic and technical leadership for delivering business capabilities while driving thought leadership and innovation with business partners.   

RESPONSIBILITIES:

• Leverage a deep understanding of the PBS landscape, our enterprise strategy, and emerging technologies to partner closely with the business to optimize current PBM solutions and technology ecosystem.
• Build and cultivate key relationships across the enterprise to align and drive expected results.
• Create & deliver new solutions by helping partners to see the art-of-the-possible and influencing the change needed to execute and deliver successfully.
• Responsible to establish, maintain and implement a technology vision and strategy aligned with a strategic roadmap and its priorities.
• The PBS+ leader will not only be critical to delivering on an aggressive portfolio and strategic roadmap but also be key in helping build out an expansion plan to transform the current technology systems to demonstrate the ability to provide innovative solutions that will be instrumental in growing our EVERNORTH business.
• Lead a global team of ~1,500 total resources comprised of Engineering, Product and Planning functions and ensure diverse, highly engaged and performing talent and an optimized structure with a focus on developing skills, capabilities, leaders and operating mechanisms that will drive horizontal innovation and successfully deliver on strategic priorities
  • Team comprised of Benefits and Eligibility, Drug Utilization Review, Sales CRM, Contractor Lifecycle Management, Supply Chain/Retail Networks, Consumer Directed Healthcare, Adjustments, Billing & Remittance, Claims Router, and Claims Adjudication
• Drive decisions relative to strategy, approach, purpose, prioritizations, trade-offs, investments, and funding, managing a budget of ~$260M.  

 Experience

• At least 15 years of experience in technology leadership, preferably within the healthcare or PBM industry.
• Proven leadership driving innovation and transformation in technology systems for healthcare companies, prepared to lead a global matrix organization of approx. 1,500 resources (700 FTE’s)
• Proven track record in leading large-scale IT initiatives, preferably in healthcare systems, or insurance technology environments.
• Ability to apply knowledge of the healthcare landscape to achieve strategic goals, including capability development and recommendations for partnerships or M&A.
• Skilled at explaining technical concepts to non-technical audiences, influencing stakeholders, vendors, and clients.
• Experience in recruiting, motivating, and developing technology teams globally.
• Experience building relationships, engaging with and shaping the perspectives of internal business partners, supporting organizations (Infrastructure, CIP, Digital, contact center) and key external customers to gain support on key issues and/or create a favorable business environment.
• Capable of adapting to changing business environments and managing ambiguity.
• Vendor management experience, especially with healthcare and PBM technology vendors, to manage partnerships and contracts.

Technical Skills

• Experience with data management and analytics platforms, especially in the context of healthcare data.
• Familiarity with cloud computing and modern IT architectures.
• Knowledge of machine learning, AI, and data analytics in optimizing PBM processes.
• Expertise in integration of PBM technology with insurance carriers, healthcare providers, and other stakeholders in the healthcare ecosystem.
• Understanding of software development methodologies (Agile, DevOps) and systems integration in healthcare environments.
• Familiarity with PBM systems such as claims processing platforms, formulary management software, and pricing engines.

Leadership and Management Skills

• Proven leadership in driving innovation and transformation in technology systems for healthcare companies.
• Ability to communicate technical concepts effectively to non-technical stakeholders.
• Strong problem-solving skills, especially in the context of integrating PBM services and technology.
• Capable of overseeing large, cross-functional teams including developers, engineers, data analysts, and healthcare professionals.
• Skilled in managing budgets, timelines, and resources for large-scale IT projects.
• Ability to balance business needs with technology innovation, ensuring scalability and efficiency of PBM systems.

Regulatory and Industry Knowledge

• In-depth understanding of Pharmacy Benefit/pharmaceutical and healthcare regulations (HIPAA, Affordable Care Act, CMS regulations, etc.).
• Knowledge of drug pricing strategies, formulary design, and trends in pharmaceutical management.
• Familiarity with healthcare interoperability standards like HL7, FHIR, and NCPDP.

CRITICAL LEADERSHIP COMPETENCIES

• Drives Vision and Purpose – Articulates a compelling vision of the positive impact the organization can make

• Innovation - creating better ways for the organization to be successful in a highly-complex environment

• Drives Results – Pushes team and cross functional partners to deliver needed results in tough circumstances and expedited timelines

• Builds Effective Teams – Builds strong identity teams that apply their diverse skills and perspectives to achieve common goals

• Action Oriented – Takes on tough challenges with sense of urgency, high energy, and enthusiasm

• Decision Quality – Makes sound and timely decisions to keep work moving forward

• Directs Work – Provides direction to direct reports and cross functional teams and removes barriers to getting work done

• Manages Complexity –  Makes sense of complex and sometimes contradictory information to effectively solve problems

• Manages Ambiguity – Operates effectively and drives work forward even when things are not certain or there is no clear way forward

• Balances Stakeholders – Anticipates and balances the needs of multiple stakeholders across Health Services and Enterprise

• Collaborates – Quickly builds partnerships and works collaboratively with others to ensure progress

• Courage – Steps up to address difficult issues and says what needs to be said

• Instills Trust – Quickly gains confidence and trust of others through honesty, integrity, and authenticity

• Communicates Effectively – Develops and delivers multi-mode communications that convey a clear message and adapts to multiple audiences

• Situational Adaptability – Adapts approach and demeanor in real time to match the shifting demands of different situations

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 276,400 - 414,600 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 and long term incentive plan.

At The Cigna Group, 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), 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, click here.

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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 need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance.  Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

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.