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Express Scripts Sr. Manager, CRD Implementation in St. Louis, Missouri

POSITION SUMMARY

The Coverage Review Department (CRD) Senior Manager - Implementations is responsible for facilitating the operational implementation phase for new client prior authorization (PA) set-up, and existing client upsells when related to coverage review and prior authorizations. This includes planning and coordinating with both client and internal cross-functional operational teams to support all aspects of setup. This position will serve as the main point of contact for the CRD operational department, and is responsible for any needed cross functional coordination. This position will ensure departmental alignment through a comprehensive understanding of all downstream impacts of project components and partner with sales and product teams to facilitate operational procedures and implementation processes for new CRD clients and products.

ESSENTIAL FUNCTIONS

  • Act as consultative CRD operational liaison between all ESI functional areas and client contacts.
  • Define project scope, develop project plans as needed, determine necessary resources and establish project timeline.
  • Provide strategic direction and guidance to both internal operational functions and client to mitigate project risks to all parties.
  • Able to clearly understand and communicate client intent decreasing disruption impact to beneficiaries.
  • Identify and manage project dependencies and critical path.
  • Represent the CRD team throughout sales process including written and oral communications.
  • Serve as CRD implementation expert.
  • Build relationship and maintain working communication with Product Management in aligning with all requirements, current and future.
  • Able to understand RFP language and ensure departmental and operational alignment.
  • Able to present to executive level clientele and influence decision-making process.
  • Ensure quality and service standards are met; including client contractual deliverables related to the implementation process.
  • Conduct project post-mortems and create recommendations based on lessons learned.
  • Identify both successful and unsuccessful project elements and establish best practices for project execution.
  • Work with sales and pro to establish implementation process and operational procedures for new products.
  • Identify opportunities to standardize, document and define procedures.
  • Identify process inefficiencies and provide innovative solutions to solve for gaps.
  • Provide executive-level updates and presentations to internal staff.

QUALIFICATIONS

  • Bachelor’s degree in Health Care, Business, or 14-18 years of experience
  • 8-12 years relevant experience in business requirements analysis or development or Master’s degree and 6-10 years relevant experience
  • General PC knowledge including Microsoft Office
  • Demonstrated ability to coordinate people and teams to project completion
  • Thorough knowledge of ESI’s systems and platforms strongly preferred
  • Demonstrated effective leadership and analytical skills
  • Advanced written and verbal communication skills are a must
  • Willingness to work a flexible schedule to accommodate business requirements

ABOUT THE DEPARTMENT

The mission of PBM Services is to meet market needs for speed, flexibility and reliability, while driving and influencing best operational practices. PBM Services includes Client and Benefit Administration, Manual Claims Processing, Eligibility, Quality Control, Implementation and the Client Service Center. These centralized functions support the client lifecycle throughout the enterprise, helping to “get it right the first time” and thereby increasing client satisfaction and reducing waste and the cost of rework.

ABOUT EXPRESS SCRIPTS

At Express Scripts, we dare to imagine a better health care system, and we’re driven to make it happen. Where some see obstacles, we see possibilities. We’re challengers, difference-makers and opportunity-seekers, united with our partners in pursuit of a simpler, more sustainable system and better health for all.

We have always acted first to take on the toughest challenges. We uniquely partner across the health care ecosystem to uncover opportunities, take action, advance health care and deliver better outcomes – like no one else can. We believe health care can do more. We are Champions For BetterSM.

Express Scripts, part of Cigna Corporation, unlocks new value in pharmacy, medical and beyond to further total health for all.

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