Sr. Payer Specialist
Irving, Texas Numéro du poste JR0113751 Catégorie Client Relationship Date de publication Jun. 27, 2024McKesson 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.
The Medically Integrated Dispensing (MID) Sr. Payer Specialist help practices optimize their medically integrated pharmacies and dispensaries through accreditation, PBM contracting, PBM audit risk mitigation, and continuous quality 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
6+ years pharmacy contracting, pharmacy quality improvement, and/or pharmacy regulatory and payer compliance.
Critical Skills
Strong experience developing internal and external relationships/partnerships
Demonstrated experience in developing performance improvement plans
Knowledge of pharmacy, pharmacy systems, and pharmacy workflow
Experience with pharmacy claims adjudication, claim rejections and associated resolutions
Effectively manage customer expectations in terms of service and issue resolution
Strong Microsoft Office skills
Additional Skills
Experience with URAC or ACHC pharmacy accreditation
Experience in practice consulting
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
Develop a proficiency in oral oncology segment and technology (product, application, platform)
Education
4-year Undergraduate College Degree or equivalent experience
Working Conditions
General office environment
Work from home
40% Travel
Physical Requirements
General office demands
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. 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 - $171,100McKesson 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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