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Manager, Managed Care & Customer Operations

Job Description:

The Manager, MCCO will be responsible for the 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.  You will play a critical role in the coordination of pharmacy service efforts, which includes direct interaction with the SPARK Care Team, home office team members, field leadership and field roles. 

Responsibilities:

  • 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 
  • Manage day-to-day coordination of patient services through the SPARK Program 
  • Identify, create, and implement services that are necessary to enhance patient retention and compliance by partnering with patient advocates/field/home office 
  • Responsible for managing pharmacy operational metrics  

Requirements:

  • 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 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
  • Customer and Sales Operations experience, strongly preferred
  • Strong analytical and problem solving background
  • Ability to operate as a team player in collaborating with multiple sales representatives, sales leadership, and internal colleagues to reach common goals
  • Highly developed communication skills
  • Self-motivated, self-directed and attention to detail  

If you are interested, please submit your resume by email to hr@corcept.com

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