Senior Director, Payer Relations and Strategy (Oncology)

Mckesson Corporation; Irving (TX); On-site; USD 180,000 - 250,000; Full time

Job summary

McKesson is seeking a senior leader to oversee contracting and payer relations for The US Oncology Network. You will lead a team across multiple geographies, negotiate complex payer agreements, and drive value-based care initiatives to maximize revenue and ensure optimal patient access.

The role requires extensive experience in managed care, strong leadership, and the ability to collaborate with executive stakeholders to shape strategic payer strategies and contract performance across practiced

Qualifications

• 13+ years of professional experience in managed care, value-based care, healthcare administration, payer relations, or oncology.
• 6+ years of diversified leadership, planning, communication, organization and people motivation skills.
• Experience developing relationships with high-level decision-makers in payer and provider environments.

Responsibilities

• Provide leadership and development of contracting team members across multiple geographies.
• Negotiate and manage designated payer agreements to achieve organizational objectives and grow revenue.
• Develop and implement fee-for-service and value-based contracting strategies with key stakeholders.
• Collaborate with executives to monitor market trends and optimize pricing and payer incentives.

Skills

Contract management

Leadership

Payer relations

Strategic thinking

Healthcare administration

Education

Bachelor's Degree

Master's Degree in Business or Healthcare Administration

Job description

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.

Responsible for developing and maintaining long-term productive relationships with practices in The US Oncology Network and third-party payers, such as commercial and governmental payers, employers, and other payer organizations. Leads a team of managed care professionals and directs the execution of managed care initiatives and strategies that will maximize opportunities between third-party payers and provider partners including hospitals, PCP networks, and employer groups. Negotiates contracts with payers that meet the financial, operational, and strategic goals and objectives for assigned practices within The US Oncology Network and coaches team to similarly perform these duties. Partners with key stakeholders and subject matter experts to develop an understanding of new therapies, technologies, and procedures, and to ensure that costs are appropriately reflected and reimbursed in managed care agreements.

Collaborates with executive leaders on the development of long and short-term practice-level strategic plans that position practices optimally within the third-party payer environment and local hospital/provider market. Facilitates personalized payer transformation strategy sessions with individual practices and develops a roadmap to accomplish strategic imperatives.

Key Responsibilities

Provide leadership and development of contracting team members, including McKesson and USON practice employees across multiple geographies

• Partners with executive leadership to determine strategic imperatives used to drive growth, goal planning, and framing shared vision

• Responsible for goal setting and performance management of direct reports

• Responsible for professional development and guidance of all team members and disciplines including managed care and value based care

• Ensures accountability for managers and direct reports

• Support leadership bench strength and support development for cross-functional partners

Develop and strengthen payer relationships:

• Prospect new preferred provider agreements, novel payment arrangements, and enhanced fee-for-service agreements aligned with strategic imperatives and disseminate to team members to finalize contract terms.

• Responsible for the successful negotiation and management of designated payer agreements including developing, evaluating and implementing, and establishing profitable payer relationships to achieve the organization’s objectives, grow and protect revenue, and support value-based care transformation across assigned practices.

• Develop and maintain payer relationships and advocate for community-based oncology services with local market payers; identifying opportunities and programs to secure enhanced relationships, reimbursement, referrals, and market presence and support expansion of patient services.

Budget

• Determines budget and advise senior management both within The US Oncology Network and practice leadership on all matters concerning net revenues in the areas of commercial Managed Care, Medicaid, and Medicare.

• Monitors and reports performance based on budgeted plan

Strategy

• Collaborate with key stakeholders to develop and execute both fee for service and value based contracting strategies

• Build self as a trusted, expert advisor with stakeholders. Provide support to executive leadership and teams on issues of managed care strategy, reimbursement, cost, payer mix, and other contract-specific issues. Respond to requests for assistance in resolving a wide range of contract performance and operational issues associated with the implementation of contracts.

• Ensure timely and effective implementation of contracts through communication with key team members.

• Collaborate with multiple internal groups which contribute to this business (US Oncology operations, Onmark operations, Finance, GPO, Innovent, Clinical Services, Pharmacy Solutions, Revenue Cycle, VBC Transformation, and Medically Integrated Pharmacy, Business Development) to monitor industry trends and identify opportunities and potential headwinds.

• Partner with Impacts Analytics to develop and evaluate contracts to optimize pricing and strategically align payer, practice, and physician incentives. Design sound agreements that drive compelling performance and optimization of quality measurements based on claims studies, actuarial evaluations, and episodic payments where gain/risk share, steerage, or other advantages to the practice are involved.

• Oversight of business development evaluations for potential integrations into The US Oncology Network.

• Collaborate with key stakeholders to design paths that prepare practices for novel payment models (i.e., case rate development, integrated networks, contract capitation, total cost of care initiatives, and shared savings models) and has a firm grasp on the analytics/practice impacts that support such payment models.

Leadership:

• Provide leadership and development of contracting direct and indirect team members, including McKesson and USON practice employees across multiple geographies

• Partners with executive leadership to determine strategic imperatives used for goal planning

• Responsible for goal setting and performance management of direct reports

• Responsible for professional development and guidance of all team members and disciplines including managed care and value based care

• Ensures accountability for managers and direct reports

• Support leadership bench strength and support development for cross-functional partners

Minimum Requirement

• Degree or equivalent experience. Typically requires 13+ years of professional experience and 6+ years of diversified leadership, planning, communication, organization, and people motivation skills (or equivalent experience).

Education

• Bachelor's Degree required; Master's in Business or Healthcare Administration preferred.

Critical Skills

• 13+ years of professional experience related to managed care, value-based care, healthcare administration, payer relations, or oncology or multispecialty practice operations.

• 6+ years diversified leadership, planning, communication, organization and people motivation skill (or equivalent experience).

• Experience working for a community-based health provider or related consulting organization, preferably in contract negotiations or value-based care

• Strong understanding of strategic and operational considerations for healthcare providers

• Experience developing relationships with high-level, decision-makers in the payer, third-party administrator and specialty practice environments with a track record of innovative network development and contracting solutions

• Experience in healthcare management in a managed care environment including significant experience in commercial payer strategies, pricing, reimbursement, and healthcare cost analysis

• Track record of directing high-performance, multidisciplinary teams

Additional Skills

• Knowledge of coordinating activities, exchanging information and clarifying needs from a Managed Care perspective with Marketing, Business Development, Finance, revenue cycle management, pharmacy operations, and the clinical team

• Experience in Oncology or specialty practice environment

• Experience and knowledge with strong executive presence, exceptional leadership skills, and superior organization skills

• Ability to create visually appealing and compelling presentation materials

• Expertise in fee-for-service and value-based care contracting with the ability to advise specialty practices

• Ability to work collaboratively in a team environment

• Ability to work effectively with people at all levels in an organization

• Ability to influence people, build relationships and collaborate

• Strong proficiency in remote and in-person public speaking and facilitating large groups

• Experience in developing content to engage large groups remotely

• Experience monitoring markets, industries, and companies to maintain and update information base by participating in industry organizations including developing new contracts, knowledge, and trends to cultivate new strategies

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