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Managed Care Manager

Job Description:

The Managed Care Manager will be responsible for pharmacy operations with respect to data validation and reporting, market access/reimbursement, trends in the healthcare environment, pricing strategy in partnership with others in the company, and vendor management.


  • Proactively work toward the identification of payer trends, pricing issues, policies and changes through payer, provider and field collaboration
  • Identify alternate funding/financial assistance program
  • Design appropriate program strategies to meet product reimbursement and patient access challenges
  • Develop solutions to provide real-time reporting analytics to sales operations
  • Analyze and draw conclusions from research and analytics and articulate key findings


  • Bachelor’s degree in business administration, engineering
  • 3-5+ years relevant experience in managed care, strategic planning, pharmaceutical
  • Knowledge of government, state and commercial insurance systems, rebates, methodology, and reimbursement policies and processes
  • Experience with specialty products acquired through specialty pharmacy
  • Experience with implementing and executing Medicare, Medicaid, and Managed Care Payer initiatives; familiar with PAP organizations
  • Familiarity with health insurance claim forms including UB-04, CMS-1500, explanation of benefits, and prior authorization forms
  • Experience with customer relationship management tools (e.g., Salesforce)
  • Strong working knowledge of healthcare industry-related datasets (e.g., IMS, WKH, NCPDP, etc.)
  • Familiar with private and public sector healthcare and the healthcare marketplace

If you are interested, please submit your resume by email to

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