Manager, Managed Care Contracting
Share
Job Location:
Virginia Beach, VA - USA
Monthly Salary:
Not Disclosed
Posted on:
20 days ago
Vacancies:
1 Vacancy
Job Summary
City/State
Virginia Beach VAWork Shift
First (Days)Overview:
Manager Managed Care Contracting
The Manager Managed Care leads medical and pharmacy managed care contracting strategies and activities for assigned third-party payors supporting Sentara Healthcare provider divisions. This role partners with clinical pharmacy and managed care leadership tooptimizereimbursement ensure contract performance and align financial and operationalobjectives. The Manager Managed Care serves as the primary liaison for a portfolio of payor relationships overseeing contract implementation issue resolution and ongoing performance. This role supports data analysis andfacilitatescoordination of day-to-day managed care operations including patient access claims adjudication and care management.
Hybrid position at 1300 Sentara Park Virginia Beach Virginia --two days remote and three days on site at Sentara Park.
There is an opportunity for Richmond (Virginia) residents to work same schedule at Sentara Health Plan in Richmond. Required to work each Wednesday at Sentara Park Virginia Beach.
Education
Bachelors degree(Required)
Experience
3 yearsofexperience in managed care contracting(Required)
3 yearsofexperiencein healthcare(Required)
We are seeking demonstrated experience in pharmacy managed care including:
Understanding of pharmacy benefit management (PBM) structures and reimbursement models (e.g. AWP MAC NADAC)
Experience negotiating pharmacy reimbursement terms and specialty pharmacy agreements
Knowledge of formulary managementutilizationmanagement and drug pricing strategies
Strong financial acumen with experience in contract modeling and reimbursement analysis
Knowledge of healthcare regulations payor requirements and value-based care arrangements preferred
Legal Resources Plan
Colleagues have the opportunity to earn an annual discretionary bonus ifestablished system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30000-member workforce. Diversity inclusion and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission to improve health every day this is a tobacco-free environment.
For positions that are available as remote work Sentara Health employs associates in the following states:
Alabama Delaware Florida Georgia Idaho Indiana Kansas Louisiana Maine Maryland Minnesota Nebraska Nevada New Hampshire North Carolina North Dakota Ohio Oklahoma Pennsylvania South Carolina South Dakota Tennessee Texas Utah Virginia Washington West Virginia Wisconsin and Wyoming.
Required Experience:
Manager
About Company
Sentara Health, is an integrated, not-for-profit health care delivery system in Virginia and North Carolina. Sentara improves health everyday.
