Operations Director, Health Plans - Express Scripts - Hybrid

Operations Director

As the Express Scripts Inc. (ESI) Health Plans Division (HPD) Operation Director (OD), you will provide operational leadership, expertise, and oversight to our complex customized clients and our front-line Account Managers.

The Operations Director is responsible for developing strategies that effectively align Express Scripts' operational services and solutions to meet the objectives of their assigned portfolio of Express Scripts clients. The position is ultimately responsible for the planning, internal coordination, implementation, maintenance, and communication of client activities and performance for their assigned book of business. This role maintains ongoing key client relationships while leading/coaching an assigned group of front-line client-facing Account Managers focused on the operational aspects of supporting clients within the assigned portfolio.

This client facing OD role will report to a Sr. Operations Director (SOD) within HPD and is ultimately responsible for all day-to-day and strategic operational activity of his/her assigned HPD client portfolio ensuring that all Service Level Agreements (SLA) meet or exceed their contractual obligations; thereby driving client satisfaction and retention. This role is intended for individuals who can establish and maintain solid working relationships with leaders from both internal and external (clients, vendors, and/or consultants) departments.

The ideal candidate will have a superior working knowledge and understanding of the pharmacy benefit industry/processes including, but not limited, to those within Commercial, Health Care Exchanges, Medicaid and Medicare lines of business.

Responsibilities include but are not limited to the following:

• Client retention via operational excellence within assigned client portfolio
• Cross-functional collaboration with areas such as Benefits, Information Technology, Regulated Markets, and Product
• Maintaining strong client relationships with complex clients to ensure retention, operational performance, and client satisfaction targets are met or exceeded
• Oversight of client resolution/escalation of client issues
• Oversight of custom technology projects or strategies
• Oversight of assigned Account Managers ensuring that they build strong client relationships that align with operational goals of those assigned client(s) and ESI
• Leading, coaching, and mentoring on-site and remote team members
• Work collaboratively with other roles on the Account Management Team
• Highlight career development opportunities, evaluate performance, and provide feedback to promote employee growth and retention
• Leading ongoing collaborative efforts with external leadership and their consultants to conduct off-site / on-site meetings and recurring webcasts as appropriate
• Champion internal advocacy for client service and member experience
• Establishment of risk management activities for client performance guarantees
• Sponsor standard and more complex projects that require development by ensuring client requirements are clearly defined, thoroughly captured, and implemented to the commitment
• Leads HPD key initiatives aimed at improving the client experience, business model, employee well-being, margin or other processes
• Champions SOP and establishes best practices as needed

Minimum Qualifications:

• Bachelor's degree in related field or equivalent work experience
• 10+ years of relevant work experience
• Self-sufficient
• An experienced organizational leader who can collaborate with all levels and can tailor the message with the right level of detail as appropriate
• Strong executive presence
• Uses good judgement and proper channels in terms of when to escalate, leveraging colleagues and leadership

• Proficient PC skills including WebEx, Microsoft Word, Excel, and PowerPoint
• Knowledge of the PBM industry
• Superior verbal and written communication skills
• Creative thinking skills
• Experience with leading teams and mentoring individuals to success

• Demonstrated ability in managing high visibility projects, often independently or through Sr. Leadership
• Resourceful with a proven ability to exercise good judgement in problem solving
• Able to manage multiple tasks simultaneously; shift priority quickly as needed
• Strategic thinking; weighs the potential risks or conflict associated with executing change and has awareness to how it may impact downstream or interdependent systems
• Ability to comprehend the business need while also anticipating questions, and addressing those proactively back to the client and/or Leadership
• Fluent with most or all Express Scripts tools used in Account management (e.g., CSP, Trend Central, CBM, Ops-Insight, CTE, Bi-Query, etc.)
• Knowledge of CMS and HHS requirements and regulations associated with Med-d and ACA
• Possesses a keen awareness to client temperature and proactively creates mitigation plans
• Takes powerful initiative to develop action plans to resolve areas of opportunity
• Proactive follow-up and understands when to raise risks/concerns
• Ability to travel overnight up to 10-15% as needed, mostly with ample notice

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.

This role is also anticipated to be eligible to participate in an annual bonus plan.

At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you need a reasonable accommodation to complete the online application process, please email View email address on talent.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.