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

Posted: Jul 29, 2026

Manager, Managed Care Contracting

Sentara - Virginia Beach, VA

Application Deadline: N/A

Health Services

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 to optimize reimbursement, ensure contract performance, and align financial and operational objectives. 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 and facilitates coordination 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

• Bachelor’s degree (Required)

Experience

• 3 years of experience in managed care contracting (Required)
• 3 years of experience in 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 management, utilization management, 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