Express Scripts Canada’s (ESC) Clinical Services team is responsible for the creation, enhancement and maintenance of ESC’s drug formularies, clinical programs. The Clinical Services team works closely with the Account Management team to support clients’ PBM needs and provides clinical input on any organizational projects or initiatives requiring clinical knowledge.
The Senior Manager, Clinical Services reports to the Director, Clinical Services and is responsible for the successful management of all clinical activities related to the development and maintenance of Express Scripts Canada’s pharmacy benefit solutions and contributes to establishing strategic goals. This position will provide direction for, and is responsible for the output of multiple disciplines towards ESC’s formularies and clinical programs and support the clients alongside the Account Management team.
This role requires leading formulary development, clinical support, drug evaluation, and clinical data maintenance and analysis activities. The Senior Manager, Clinical Services will work closely with the Senior Manager, Prior Authorization and Drug Plan Management to provide clients with pharmacy benefits solutions.
The responsibilities for this position will include, but are not limited to:
Leading the development, implementation, and maintenance of clinical formularies and programs
Ensure that service quality and service level agreements (SLA) are achieved; develop and monitor key performance indicators to identify process improvement, system upgrades and risk management opportunities.
Analyze drug claims data with a clinical view to provide valuable and actionable insights to clients, to present relevant trends to PBM industry and to derive meaningful information for customers
Providing strategic direction and sound clinical expertise to cross-functional teams for ESC’s clinical products and services
Leading and providing growth development opportunities to the Clinical pharmacists
Supporting and contributing to the strategic direction of Clinical Services
Acting as a clinical leader internally and externally (at industry conferences, events, committees, professional associations, client meetings, etc)
Acts as Clinical Services business leader on ESC committees and working groups
Promote Clinical Services to existing and new clients to align with strategic objectives of ESC
This position has ownership for managing performance and metrics, workflow management, departmental standard measurements and core client service delivery. Responsibilities include directing operations, creating, executing and managing on procedures and resolution of customer complaints and inquiries. This leader utilizes in-depth professional knowledge, guided by functional practices to implement and execute best practice strategies within the Clinical team.
ESSENTIAL FUNCTIONS:
Vision and Strategy: Develop vision and strategy for the Clinical Services team, including both, short-term and long-term goals, that align with corporate strategic direction
Leadership: Lead and engage teams in achieving strategic goals/objectives, developing and implementing initiatives that meet the goals, maximizing outcomes. Foster a growth-oriented culture though coaching and mentoring to expend team proficiency, skill development and cross training to create bench strength and alignment with corporate goals
Workflow Management: Develop and maintain monitors and controls to maximize ability to meet service standards and objectives for turnaround time and quality
Ensure that all contractual, service quality and service level agreements (SLAs) are achieved
Oversee operational processes and support process improvements, efficiencies and automation to optimize results
Ensures teams to create and update documentation for day to day operations, clinical formularies, programs, etc
Develop ongoing operational metrics and to monitor work conducted by the team in support of our clients and ensure visibility on status of service delivery along with insights on trends
Develop, monitor and assess key performance indicators to support data driven decisions in mitigating risk and exploring opportunities to streamline, automate and improve existing service delivery
Clinical Services Management:
Lead the clinical pharmacists in development, maintenance and enhancement of clinical formularies and programs
Champion ESC’s Drug Evaluation Committee (DEC) and Validation (VAL) meetings to
review new drugs and new indications
track and provide ESC and clients with industry knowledge, including legislative updates (national and provincial), drug pipeline tracking etc
Serve as a member of the Value Assessment Committee (VAC) to ensure decisions are aligned with formularies and clinical programs while supporting the operationalization of VAC recommendations
Support the creation and enhancement of Products with Clinical Services expertise
Lead the development and delivery of ESC’s annual Outcomes conference and Drug Trend Report, Drug Pipeline reports, and other clinical reports
Resource Management: Foster a people first culture that develops the skills and capabilities of team members to enable personal and business growth
Work cross functionally with ESC teams to enable best holistic outcomes for the clients and organization
QUALIFICATIONS:
BS in Pharmacy; Doctor of Pharmacy required.
Minimum 5 years of experience in PBM and/or private healthcare insurance preferred.
Advanced clinical experience/training/certifications preferred. MBA is preferred
License to practice pharmacy in Canada
Strong analytical skills to derive meaningful insights for ESC, Clients and PBM
Strong organizational, communication (written, oral, and presentation) and PC skills including advanced research and analytical skills
Excellent written and verbal communication skills to convey complex concepts to technical and non-technical audiences
Ability to collaborate effectively in team environment and effectively manage multiple projects simultaneously. Excels at fostering cross functional teamwork and partnerships
Resourcefulness skills required; Identify challenges that may occur and address potential solutions with your team to prevent or minimize obstacles before they arise
Self-starter able to work in a dynamic, fast paced environment and make independent decisions
Proven skills in time management, planning, prioritization, change management and employee performance management
Strong client service focus through adaptability, flexibility and a commitment to quality
Bilingual; Fluent in French and English (verbal and written) is an asset
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.
It will be a condition of employment that the successful candidate obtains an Enhanced Reliability Clearance from the Federal Government. The candidate will be required to provide supporting documentation to receive clearance if required.
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.
If you require accommodation in completing the online application process, please email: eschr2@express-scripts.com Do not email eschr2@express-scripts.com for an update on your application or to provide your resume as you will not receive a response.