Clinical Program Senior Advisor – Express Scripts – Hybrid; Strategic Markets – Prime

POSITION SUMMARY

This role requires the combination of a strong clinical background, deep understanding of utilization management criteria, and ability to read pharmaceutical contracts, along with business acumen and financial analytical skills to identify and execute upon strategic opportunities that align with clinical/financial objectives. The Clinical Program Senior Advisor, Strategic Markets is responsible for assessing formulary positioning alongside applicable utilization management policies to determine client eligibility for rebates, ultimately providing quality assurance evaluations that will promote accurate rebate invoicing.

This role will work cross-functionally with the Pharmaceutical Contracting, Clinical Consulting and Pharmaceutical Invoicing teams to ensure formulary tier and clinical rules are interpreted correctly and will evaluate benefit set up impacts on rebated drug products. Reporting to the Clinical Program Director, this position provides clinical support in documenting formulary placement/positioning and utilization management policies and procedures for the analysis and appropriate determination of client eligibility for rebate enhancement and exclusion options.

Additionally, this role offers consultative clinical support in the interpretation of rebate requirements contained within manufacturer rebate agreements, as well as advice regarding impact assessments following any proposed or implemented changes to formul