Pharmacy Benefits Contracting Manager

Sentara Health; Virginia Beach (VA); Hybrid; USD 95,000 - 130,000; Full time

Benefits offered by this job

Medical, Dental, Vision plans

401k/403B with Employer Match

Tuition Assistance

Job summary

Sentara Health in Virginia Beach seeks a Manager, Managed Care Contracting to lead contracting strategies for medical and pharmacy payors. You will collaborate with clinical and managed care leaders to optimize reimbursement, ensure contract performance, and align financial and operational objectives.

You will oversee payor relationships, contract implementation, issue resolution, and ongoing performance. This hybrid role requires a bachelor’s degree and 3+ years in managed care contracting and

Qualifications

• Bachelor's degree required.
• 3+ years of experience in managed care contracting required.
• 3+ years of experience in healthcare required.
• Experience in pharmacy managed care with PBM structures and reimbursement models.

Responsibilities

• Lead medical and pharmacy managed care contracting strategies for assigned payors.
• Partner with clinical, pharmacy, and managed care leadership to optimize reimbursement and contract performance.
• Serve as primary liaison for payor relationships, overseeing contract implementation and issue resolution.
• Support data analysis and daily managed care operations including patient access and claims adjudication.

Skills

PBM knowledge

Pharmacy reimbursement

Contract negotiations

Formulary management

Utilization management

Drug pricing strategies

Financial analysis

Payor requirements

Education

Bachelor's degree

Job description

Sentara Health in Virginia Beach seeks a Manager, Managed Care Contracting to lead contracting strategies for medical and pharmacy payors. You will collaborate with clinical and managed care leaders to optimize reimbursement, ensure contract performance, and align financial and operational objectives.

You will oversee payor relationships, contract implementation, issue resolution, and ongoing performance. This hybrid role requires a bachelor’s degree and 3+ years in managed care contracting and