Regional Director, Managed Care

Vaga não está no LinkedIn

🕒 Julho 30

🤠 Texas – Remoto

🤠 Texas – Remote

💵 $118.100 - $196.900 / ano

⏰ Tempo Integral

🔴 Especialista

👔 Diretor

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McKesson

SiteLinkedInTodas as Vagas

10.000+ funcionários

Fundada em 1833

💼 Consultoria

📦 Logística

🏥 Saúde

Consulting • Logistics • Healthcare

A McKesson é uma líder diversificada em saúde, especializada em distribuição farmacêutica, suprimentos médicos e serviços de saúde. Suas soluções facilitam o acesso de pacientes a terapias transformadoras, apoiam operações eficientes para farmácias, sistemas de saúde e clínicas, e abordam questões críticas como a escassez de medicamentos por meio de uma cadeia de suprimentos resiliente. A McKesson oferece serviços abrangentes como software de gestão de farmácias, consultoria e soluções tecnológicas para práticas especializadas, focando em melhorar os resultados de saúde e promover a indústria farmacêutica. Eles trabalham em estreita colaboração com empresas biofarmacêuticas para melhorar o acesso a medicamentos, adesão e comercialização, enquanto apoiam práticas oncológicas e biofarmacêuticas por meio de insights orientados por dados e evidências do mundo real.

Descrição

• Advise specialty provider practices on managed care contracting, payer strategy, reimbursement performance, market access, and payer relationship management. • Review, analyze, negotiate, and support renewal of commercial, Medicare Advantage, Medicaid managed care, and other payer agreements. • Develop payer-specific strategies that support favorable reimbursement, specialty therapy access, operational sustainability, and long-term practice goals. • Evaluate contract terms, fee schedules, reimbursement methodologies, prior authorization requirements, administrative provisions, and payer-related barriers that may affect practice performance. • Monitor payer policy changes, reimbursement trends, network developments, market activity, and competitive dynamics; translate findings into clear recommendations. • Partner with provider practices to support contract administration, reporting, payer communications, implementation planning, and ongoing management of managed care initiatives. • Prepare payer strategy summaries, negotiation talking points, contract opportunity assessments, and other materials that support customer and internal decision-making. • Represent managed care contracting capabilities in customer meetings, regional business reviews, payer strategy discussions, internal planning sessions, and other business forums.

🎯 Requisitos

• Bachelor’s degree in finance, accounting, business, healthcare administration, or a related field; advanced degree preferred. • 7+ years of relevant experience. • 5 or more years of progressive healthcare experience in managed care contracting, payer relations, provider reimbursement, healthcare finance, or specialty practice support. • Experience reviewing, interpreting, negotiating, or supporting managed care contracts, including reimbursement terms, rate structures, fee schedules, administrative provisions, and renewal strategy. • Strong understanding of healthcare reimbursement, payer policy, commercial and government payer dynamics, network strategy, specialty markets, and value-based care concepts. • Ability to analyze payer, reimbursement, and contract performance data and translate findings into actionable recommendations. • Strong written, verbal, presentation, negotiation, relationship management, and consultative skills. • Proficiency with Microsoft Word, Excel, PowerPoint, Salesforce.com, Smartsheet, and other analytical or reporting tools. • Experience in specialty markets such as Oncology, Rheumatology, Neurology, Ophthalmology, Gastroenterology, or other provider-administered therapy environments is highly desirable.

🏖️ Benefícios

• Competitive compensation package • Annual bonus opportunities • Long-term incentive opportunities