Sr. Specialist, MID Payer Services & Accreditation
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.
Role Summary
The Medically Integrated Dispensing (MID) Sr. 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
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Ability to guide practices through URAC, ACHC, and other accreditations
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Assists practices with integration and maintenance of accreditation requirements
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Assists practices with operation of continuous improvement programs
Contracting Support
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Assists practices with development of payer contracting strategies to optimize network access and reimbursement
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Guides practices through contract negotiation
Patient Access Strategies
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Advises practices on how to build patient advocacy
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Helps practices build plan sponsor engagement strategies
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Assists practices with building long-range contracting strategies
Minimum Requirement
Degree or equivalent and typically requires 7+ years of relevant experience.
Education
Bachelor's Degree or equivalent experience
Critical Skills
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7+ years pharmacy contracting, pharmacy quality improvement, and/or pharmacy regulatory and payer compliance
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3+ Years of experience with URAC or ACHC pharmacy accreditation
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3+ Years of experience in practice consulting
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Demonstrated experience in developing customer performance improvement plans
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Knowledge of pharmacy systems, pharmacy and pharmacy workflow
Additional Knowledge & Skills
- Specialty Pharmacy experience a plus
- Wholesale Distributor experience a plus
- Community Oncology experience a plus
- Experience in provider consulting a plus
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Knowledge of PBM audit targeting and audit risk mitigation a plus
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Experience with pharmacy claims adjudication, claim rejections and associated resolutions a plus
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Effectively manage customer expectations in terms of service and issue resolution
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Develop a proficiency in orals oncology segment and technology (product, application, platform)
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Develop collaborative internal and external relationships/partnership
Expected Competencies
- Customer focused
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Able to speak with physicians, physician practice staff, pharmacists, and pharmacy staff
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Excellent problem-solving and decision-making skills
- Strong interpersonal skills
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Self-motivated and results-orientated that requires little direction or direct supervision
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Effectively mana