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Senior Payer Specialist, Medically Integrated Dispensing

Irving, Texas Numéro du poste JR0121425 Catégorie Client Relationship, Customer Service & Relations Date de publication Nov. 21, 2024
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McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve – we care.

What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow’s health today, we want to hear from you.

McKesson has an opening for a Senior Payer Specialist, Medically Integrated Dispensing.

The Medically Integrated Dispensing (MID) Senior Payer Specialist help practices optimize their medically integrated pharmacies and dispensaries through accreditation and continuous improvement initiatives. Responsibilities include working with practices to gain and maintain accreditation, develop, and maintain continuous quality improvement programs. Acts as a consulting advisor to practices, to optimize patient access, achieve patient advocacy, build plan sponsor partnerships, and develop contracting strategies. This position works closely with the McKesson Account Executives, MID account management and optimization teams to ensure high-quality and consistent service to practices.

The position requires subject matter expertise in pharmacy contracting, Pharmacy Service Administration Organizations (PSAOs), pharmacy credentialing and accreditation. Keeps up-to-date knowledge of the industry, competition, and enhances awareness within retain and specialty pharmacy business models and the medically integrated dispensing segment. This position requires excellent communication, customer service and follow-up skills.

Key Responsibilities

Pharmacy & Dispensary Accreditation and continuous improvement

  • Ability to guide practices through URAC, ACHC, and other accreditations.
  • Assists practices with integration and maintenance of accreditation requirements.
  • Assists practices with operation of continuous improvement programs.

Contracting Support

  • Assists practices with development of payer contracting strategies to optimize network access and reimbursement.
  • Guides practices through contract negotiations.

Patient Access Strategies

  • Advises practices on how to build patient advocacy.
  • Helps practices build plan sponsor engagement strategies.
  • Assists practices with building long-range contracting strategies.

Minimum Requirements & Education

  • 7+ years’ experience creating and executing test plans, test cases, and conducting system testing is required.
  • Bachelor’s degree in computer science or equivalent discipline or 4+ years of equivalent work experience required.

Critical Skills

  • 5+ years pharmacy contracting, pharmacy quality improvement, and/or pharmacy regulatory and payer compliance.
  • 3+ Years of experience with URAC or ACHC pharmacy accreditation.
  • 3+ Years of experience in practice consulting.
  • Demonstrated experience in developing customer performance improvement plans.
  • Knowledge of pharmacy systems, pharmacy, and pharmacy workflow.

Additional Skills

  • Specialty Pharmacy experience a plus.
  • Community Oncology experience a plus.
  • Experience in provider consulting a plus.
  • Knowledge of PBM audit targeting and audit risk mitigation a plus.
  • Experience with pharmacy claims adjudication, claim rejections and associated resolutions a plus.
  • Effectively manage customer expectations in terms of service and issue resolution.
  • Develop a proficiency in orals oncology segment and technology (product, application, platform).
  • Develop collaborative internal and external relationships/partnership.

Expected Competencies

  • Customer focused.
  • Able to speak with physicians, physician practice staff, pharmacists, and pharmacy staff.
  • Good problem-solving and decision-making skills.
  • Strong interpersonal skills.
  • Self-motivated and results-orientated that requires little direction or direct supervision.
  • Effectively manages complex projects with often competing deadlines.
  • Team player.
  • Ability to manage timelines and goals.
  • Strong analytical and business skills.
  • Ability to operate in a fast-paced, dynamic business environment.
  • Proficient in Microsoft Office & technologically savvy.

Working Conditions

  • General office environment.
  • Able to travel domestically 50% of the time.
  • Must be authorized to work in the US unrestricted – This position is not eligible for sponsorship.

We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, please click here.

Our Base Pay Range for this position

$102,700 - $171,100

McKesson is an Equal Opportunity Employer

McKesson provides equal employment opportunities to applicants and employees and is committed to a diverse and inclusive environment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age or genetic information. For additional information on McKesson’s full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page.

Join us at McKesson!

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