Sr. Specialist, MID Payer Services & Accreditation

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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

• 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 negotiation

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 Requirement

Degree or equivalent and typically requires 7+ years of relevant experience.

Education

Bachelor's Degree or equivalent experience

Critical Skills

• 7+ 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 Knowledge & Skills

• Specialty Pharmacy experience a plus

• Wholesale Distributor 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

• Excellent 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 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

Travel:

• Able to travel up to 40% of the time.

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

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McKesson is an Equal Opportunity Employer

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

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