Regional Director, Managed Care

Job not on LinkedIn

🕒 5 days ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $118.1k - $196.9k / year

⏰ Full Time

🔴 Lead

👔 Director

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McKesson

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1833

💼 Consulting

📦 Logistics

🏥 Healthcare

Consulting • Logistics • Healthcare

McKesson is a diversified healthcare leader specializing in pharmaceutical distribution, medical supplies, and healthcare services. Their solutions facilitate patients' access to life-changing therapies, support efficient operations for pharmacies, health systems, and clinics, and address critical issues such as drug shortages through a resilient supply chain. McKesson provides comprehensive services such as pharmacy management software, consulting, and technology solutions for specialty practices, focusing on improving health outcomes and advancing the pharmaceutical industry. They work closely with biopharma companies to enhance medication access, adherence, and commercialization while supporting oncology and biopharma practices through data-driven insights and real-world evidence.

📋 Description

• 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.

🎯 Requirements

• 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.

🏖️ Benefits

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