City/State
Virginia Beach, VAWork Shift
First (Days)Overview:
Manager, Managed Care Contracting
The Manager, Managed Care leads medical and pharmacy managed care contracting strategies and activities for assigned third-party payors, supporting Sentara Healthcare provider divisions. This role partners with clinical, pharmacy, and managed care leadership to optimize reimbursement, ensure contract performance, and align financial and operational objectives. The Manager, Managed Care serves as the primary liaison for a portfolio of payor relationships, overseeing contract implementation, issue resolution, and ongoing performance. This role supports data analysis and facilitates coordination of day-to-day managed care operations, including patient access, claims adjudication, and care management.
Hybrid position at 1300 Sentara Park, Virginia Beach, Virginia --two days remote and three days on site at Sentara Park.
There is an opportunity for Richmond (Virginia) residents to work same schedule at Sentara Health Plan in Richmond. Required to work each Wednesday at Sentara Park, Virginia Beach.
Education
Bachelor’s degree (Required)
Experience
3 years of experience in managed care contracting (Required)
3 years of experience in healthcare (Required)
We are seeking demonstrated experience in pharmacy managed care, including:
Understanding of pharmacy benefit management (PBM) structures and reimbursement models (e.g., AWP, MAC, NADAC)
Experience negotiating pharmacy reimbursement terms and specialty pharmacy agreements
Knowledge of formulary management, utilization management, and drug pricing strategies
Strong financial acumen with experience in contract modeling and reimbursement analysis
Knowledge of healthcare regulations, payor requirements, and value-based care arrangements preferred
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission “to improve health every day,” this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
Skills Required
- Bachelor's degree
- 3 years of experience in managed care contracting
- 3 years of experience in healthcare
- Experience in pharmacy managed care including PBM structures and reimbursement models (e.g., AWP, MAC, NADAC)
- Experience negotiating pharmacy reimbursement terms and specialty pharmacy agreements
- Knowledge of formulary management, utilization management, and drug pricing strategies
- Strong financial acumen with experience in contract modeling and reimbursement analysis
- Knowledge of healthcare regulations, payor requirements, and value-based care arrangements
Sentara Healthcare Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Sentara Healthcare and has not been reviewed or approved by Sentara Healthcare.
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Parental & Family Support — Four weeks of paid parental leave at full base pay and two weeks of job‑protected family caregiver leave support major life and care needs. Emergency back‑up care and reimbursements for infertility, adoption, and surrogacy further bolster family support.
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Retirement Support — A 401(A) plan alongside 403(B)/401(K) employer matching is designed to strengthen long‑term financial security. Company‑paid life insurance with buy‑up options adds additional protection for families.
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Flexible Benefits — Choice of medical plan designs and dental/vision options enables tailoring coverage to individual needs. An annual election between tuition assistance and student‑loan repayment offers flexibility to align with financial or education priorities.
Sentara Healthcare Insights
What We Do
Sentara Healthcare celebrates a 130-year history of innovation, compassion and community benefit. Based in Norfolk, VA, Sentara is a diverse not-for-profit family of 12 hospitals, an array of integrated services and a team of nearly 30,000 strong on a mission to improve health every day. This mandate is pursued through a disciplined strategy to achieve Top 10% performance in key measures through shared best practices, transformation of primary care through clinical integration and strategic growth that adds value to the communities we serve in Virginia and North Carolina.
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