Hybrid Manager, Managed Care Contracting

National Home Infusion Association; Virginia Beach (VA); Hybrid; USD 90,000 - 130,000; Full time

Job summary

Sentara Healthcare in Virginia Beach seeks a Manager, Managed Care Contracting to lead contracting strategies for third-party payors, partnering with clinical, pharmacy and payor leadership to optimize reimbursement, ensure contract performance, and align financial and operational goals.

This hybrid role supports data analysis and coordination of day-to-day managed care operations, including patient access, claims adjudication and care management, while serving as a liaison for payor

Qualifications

• Bachelor’s degree required.
• 3 years of experience in managed care contracting.
• 3 years of experience in healthcare.
• Experience in pharmacy managed care and PBM structures preferred.

Responsibilities

• Lead medical and pharmacy managed care contracting strategies for third-party payors.
• Serve as primary liaison for payor relationships, overseeing contract implementation and performance.
• Support data analysis and coordination of day-to-day managed care operations (patient access, claims adjudication, care management).

Skills

PBM structures knowledge

Reimbursement negotiation

Formulary management

Utilization management

Drug pricing strategies

Contract modeling

Financial acumen

Regulatory knowledge

Payor relationship management

Education

Bachelor's degree

Job description

Sentara Healthcare in Virginia Beach seeks a Manager, Managed Care Contracting to lead contracting strategies for third-party payors, partnering with clinical, pharmacy and payor leadership to optimize reimbursement, ensure contract performance, and align financial and operational goals.

This hybrid role supports data analysis and coordination of day-to-day managed care operations, including patient access, claims adjudication and care management, while serving as a liaison for payor