Director of Regulated Markets, CDAG/ODAG - Express Scripts - Hybrid

Job Description: Director for Regulated Markets - CDAG/ODAG

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Role Summary :

The Director of Regulated Markets is responsible for Coverage Review and Determinations for Medicare Part B and Part D, Medicaid, Marketplace or Healthcare Reform (HCR) and Commercial.

This position will have business and product ownership, including strategic direction, project support of technical requirements to ensure ongoing compliance, Center for Medicare and Medicaid (CMS) Audit support and end-to-end ownership of Coverage Review letters, including Commercial.

The role will be responsible for ensuring CDAG/ODAG requirements meet legal and compliance requirements as well as the needs of clients and business partners.

This position will be responsible for a team of individuals that lead multiple projects and initiatives that reach across the organization as well as ongoing day-to-day product management.

This role will require strategic planning, managing stakeholder priorities, overseeing delivery, execution and oversight of daily operations.

This individual will work with cross-functional partners and leaders to build trusted relationships that enable business objectives to be met.

The ideal candidate will have a broad based knowledge of Regulated Markets, a strategic mindset, the ability to influence and drive change and the capability to create and drive new processes.The successful leader will exemplify Cigna's high-performance culture and have the ability to operate in a sometimes ambiguous and high-paced environment.

A successful candidate must be comfortable in an environment of dynamic change and evolution .

In its current capacity, the Director will be expected to manage a team of 8 individuals (3 direct reports; 5 indirect).

Essential Functions:


* Analyze existing processes/systems to ensure legal/compliance requirements are met as well as business and client needs



* Responsible for area performance, inclusive of key KPIs, minimizing and mitigating business risks


* Coordinate with cross-functional partners to understand, analyze and ultimately implement improvements, increase operational efficiency and/or address gaps in CDAG/ODAG


* Provide influence, subject matter expertise and strategic support on new product launches within the organization that affects CDAG/ODAG


* Builds constructive and effective relationships across the company


* Implement applicable regulations with vague/ambiguous requirements in a dynamic regulatory environment


* Optimize core business processes, introduce innovative ideas, and foster operational excellence across the organization


* Effectively communicate st...