Risk Management Analyst

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.

This is an essential role for the business with a significant impact on customer experience and financial well-being. The Analyst is responsible for resolving all customer inquiries regarding reimbursement issues related to our Central Pay service in a close collaboration with customer service and field engagement teams and leadership. This individual is also responsible for execution of risk-mitigation reimbursement holds, creation of customer-facing and internal reporting, central pay activity research and making all necessary pharmacy updates in the system, ensuring accuracy and completion of pharmacy and reimbursement activity information. Decisions by this associate will impact McKesson reputation, revenue, customer retention, legal risk/activity, McKesson financial obligations and millions of dollars of organizational, bad-debt risk. To be successful, this must be a highly motivated professional with exceptional attention to detail, analytical, planning, collaboration, and communication skills

Key Responsibilities

Customer Support

• Responsible for the timely resolution of customer research tickets to address questions and/or concerns related to daily payments made by PSAO from PBMs participating in the central payment program. The resolution of these tickets will require extensive analysis of internal customer data sets, using tools such as SQL/PLSQL and Excel, while applying applicable contract language, understanding of Managed Care and feedback from PSAO external PBM partners.

• Responsible for responding to ad-hoc customer report requests related to PSAO central payment program, using tools such as SQL/PLSQL and Excel, and communicating analysis of data to Internal Stakeholders to allow for successful follow-up with the customer

PSAO Central Pay Management

• Assist with tasks related to the management of effective rate contracts including reviewing terminating customers and their financial risk post-membership.

• Regularly reviews customer Audit notifications from PBM partners and bankruptcy notifications to determine when additional action is needed from the business to reduce risk.

• Manage company financial obligations by regularly reviewing incoming money for terminated customers and collecting against previous balances that have been written off.

• Prepares reports for Pharmacy Investigation Committee meetings by researching and reviewing pharmacy payment history and risk to assist the committee in making decisions on customer relationships.

• Responsible for remitting payment to PSAO Central Pay vendors in timely fashion to ensure satisfaction of contractual obligations.

• Completes audits of membership and bank records to ensure accuracy and validity of data.

• Assist in the development of new processes and procedures related to PSAO Central Pay Risk Management.

Business Continuity

• Develops, implements, and maintains risk management policies and procedures to ensure organizational compliance, operational efficiency, and alignment with regulatory requirements.

• Regularly reviews and updates existing policies to reflect changes in business processes, industry standards, and applicable laws.

• Maintains document repository of policies and procedures for PSAO Central Pay

• Primary back-up for Senior Risk Management Analyst - The Analyst will be cross-trained in various time-sensitive and high-visibility tasks and act as the primary back-up to the Senior Risk Management Analyst. These two positions will work very closely to ensure no gaps in responding to escalated customer issues. These tasks can be wide and varied with limited training.

Business improvement

• Support training of Pharmacy Engagement Team members by facilitating the exchange of training material related to PSAO Central Pay with Pharmacy Engagement Senior Trainer in a timely manner

• Execution of projects to drive continuous improvement within the Operations Department, including significant involvement in the development of a new payment and data processing application by providing insight into current business processes and feedback to developers

Minimum Requirement

Degree or equivalent and typically requires 4+ years of relevant experience.

Education

4-year degree in accounting or related field or equivalent experience

Critical Skills

• 4+ year experience in accounting, finance, finance analytics or similar experience

• Advanced MS Excel Proficiency (v-look ups, pivot table, functions, data manipulation, etc.)

• Strong SQL Query Proficiency.

• Fundamental accounting methodologies and practices experience.

• Exceptional analytical skills - researching customer issues, analyze data anomalies and root cause.

• Strong understanding of X12 standards used in 835 file format.

• Excellent communication skills while explaining complex problems.

• A self-starter and problem solver, persistent and goal oriented.

Specialized Knowledge/Skills

• Expertise in MS Office--Excel, Word, PowerPoint, Visio; SQL database and queries.

• Customer-oriented with strong ability for trouble-shooting and issue resolution.

• Knowledge of managed care, from a retail pharmacy or PBM perspective, a plus

• Must be flexible and thrive in a fast-pace environment with the ability to work on multiple tasks simultaneously

Physical Requirements / Working Conditions

• Remote work experience

This description is general in nature and is not intended to be an exhaustive list of all responsibilities. Other duties may be assigned as needed to meet company goals.

Candidates must be authorized to work in USA. Sponsorship is not available for this role.

We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, pleaseclick here.

Our Base Pay Range for this position

McKesson is an Equal Opportunity Employer

McKesson provides equal employment opportunities to applicants and employees and is committed to a diverse and inclusive environment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age or genetic information. For additional information on McKesson's full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page.

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