VP, PBS Technology

Cigna Healthcare•St. Louis, MO

2d•$276,400 - $414,600•Remote

About The Position

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.

Requirements

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.
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.
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.
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.
Articulates a compelling vision of the positive impact the organization can make
Creating better ways for the organization to be successful in a highly-complex environment
Pushes team and cross functional partners to deliver needed results in tough circumstances and expedited timelines
Builds strong identity teams that apply their diverse skills and perspectives to achieve common goals
Takes on tough challenges with sense of urgency, high energy, and enthusiasm
Makes sound and timely decisions to keep work moving forward
Provides direction to direct reports and cross functional teams and removes barriers to getting work done
Makes sense of complex and sometimes contradictory information to effectively solve problems
Operates effectively and drives work forward even when things are not certain or there is no clear way forward
Anticipates and balances the needs of multiple stakeholders across Health Services and Enterprise
Quickly builds partnerships and works collaboratively with others to ensure progress
Steps up to address difficult issues and says what needs to be said
Quickly gains confidence and trust of others through honesty, integrity, and authenticity
Develops and delivers multi-mode communications that convey a clear message and adapts to multiple audiences
Adapts approach and demeanor in real time to match the shifting demands of different situations

Nice To Haves

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.

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.