Regional Director, Managed Care

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🔥 0 minutes 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

⚕️ Healthcare Insurance

💊 Pharmaceuticals

🧬 Biotechnology

Healthcare Insurance • Pharmaceuticals • Biotechnology

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 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, and payer-related barriers that may affect practice performance • Monitor payer policy changes, reimbursement trends, and market activity; translate findings into clear recommendations • Partner with provider practices to support contract administration, reporting, payer communications, and management of managed care initiatives • Prepare payer strategy summaries, negotiation talking points, and other materials that support decision-making • Represent managed care contracting capabilities in meetings and 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 • 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 • Ability to work independently in a remote environment, manage multiple priorities, and support customers across varied markets and payer landscapes • Proficiency with Microsoft Word, Excel, PowerPoint, Salesforce.com, Smartsheet, and other analytical or reporting tools

🏖️ Benefits

• Competitive compensation package • Annual bonus or long-term incentive opportunities