• Job Description

  Req#: JR0095926

  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.

  Company Profile

  McKesson Corporation is a global leader in healthcare supply chain management solutions, retail pharmacy, community oncology and specialty care, and healthcare information solutions. McKesson partners with pharmaceutical manufacturers, providers, pharmacies, governments, and other organizations in healthcare to help provide the right medicines, medical products, and healthcare services to the right patients at the right time, safely and cost-effectively.

  United by our I2CARE shared principles, our employees work every day to innovate and deliver opportunities that make our customers and partners more successful - all for the better health of patients. McKesson has been named a “Most Admired Company” in the healthcare wholesaler category by FORTUNE, a “Best Place to Work” by the Human Rights Campaign Foundation, and a top military-friendly company by Military Friendly. For more info, visit www.mckesson.com.

  We take pride in our culture of connection and believe in a workplace where everyone can be their full, authentic self. We welcome and encourage veterans, individuals with disabilities and others with diverse perspectives to join our growing team. Your unique perspective and experience are valuable assets that can translate into a rewarding career path with us.

  Job Summary

  McKesson is seeking a Senior Risk Management Analyst.

  This is a key and influential role, leveraging creativity, governance, and advanced analytics to identify, evaluate, mitigate, and monitor the organizational risk related to our managed care Consolidated Reimbursement Program, also known as Central Pay. This functionality exposes the business and our 6,200+ pharmacy customers to unlimited financial risk, which has been averaging $15 - $30 million in bad debt at a given time.

  This analyst will develop and maintain successful, forward-thinking risk mitigation strategies and policies in a manner that supports innovation, protects our customers, our business, and shareholders by considering themes, opportunity patterns and scale across functional areas and the enterprise.

  The Sr Analyst is responsible for risk oversight of several businesses within the PHS Organization: Payer Solutions (Health Mart Atlas/HMA, Atlas Specialty, McKesson Pharmacy Medical Contracting/MPMC) and ProviderPay reconciliation solution. Their decisions and policies also impact financial outcomes, legal action, reputation, and customer satisfaction/retention across multiple McK BUs: Community Pharmacy and Health (CPH), McKesson Health Systems (MHS), Medically Integrated Dispensaries (MIDs) including US Oncology, and Strategic National Accounts (SNA).

  This role reviews and analyzes significant amounts of data and trends, PBM and Pharmacy contracts, payer policies / procedures, state and federal regulations, industry practices and evolving fraud schemes to identify and measure risk factors across our network pharmacies. They then develop and oversee risk mitigation strategies and capabilities, set policies, and establish procedures across multiple BUs (CPH, MHS, MID/USON, SNA, RxO) and PHS Organization related to Central Pay risk mitigation. This individual collaborates with teams across multiple workgroups and disciplines, including Field / Distribution Sales across all BUs and Customer Segments, Customer Service, Credit, Legal, and Treasury to ensure awareness and support around these policies and risk mitigation strategies. Finally, they provide expertise and are responsible for addressing most complex customer issues related to Central Pay reimbursements and business livelihood, partnering closely with other teams and disciplines, like McKesson Distribution / field sales, legal, credit, etc.

  Decisions by this senior 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 Risk Management professional with excellent leadership, project management, analytical, planning, collaboration, strategic thinking, and communication skills.

  Key Responsibilities in priority order

  1 – Identifying and assessing risk factors, drivers, and implications, including financial, legal, and reputational outcomes, as well as impact and effectiveness of mitigation strategies

  • Analyzing significant amounts of data from various sources, including distribution purchasing, claim activity, reimbursement amounts, drug / NDC details and more to identify patterns and unusual trends indicative of potential loss/fraud. This includes reviews for accuracy, completeness, and adherence to policies and regulations, and could involve conducting audits or investigations to identify potential improper activities such as fraud, waste, abuse, and errors.
  • Monitoring policies and contractual requirements outlined in PBM / Government Payer and Pharmacy agreements as they relate to Consolidated Reimbursement program. Partner with PBM Relations and Legal to ascertain applicable contract requirements and associated risk exposure.
  • Staying up-to-date with state and federal industry regulations, laws, and best practices related to prescription claims and reimbursements to ensure compliance and effectively identify and manage risks. Conduct ongoing reviews of mitigation processes and procedures and apply industry insights for continuous improvements.

  2 – Establishing and overseeing mitigation strategies, controls, and processes.

  • Based on analysis and assessment, developing strategies to reduce potential losses and mitigate legal risk while meeting our contractual obligations.
  • This role is responsible for setting policies and establishing processes, implementing internal control methodologies, process improvements, and developing and maintaining fraud detection algorithms and monitoring systems.
  • They will instruct other teams’ activities and provide direction to Customer Service, McKesson Field, Legal and HMA Field Engagement associates and senior leadership on the approach and decisions related to each customer, considering their financial needs and the business risk.
  • Monitoring and reporting - providing insights and recommendations to senior management on the effectiveness of risk management strategies and processes. This includes generating reports, presenting findings and trends, and making recommendations for improvement.

  3 – Collaborating and building relationships with stakeholders to gain alignment, as effective communication and collaboration are crucial to addressing risks and implementing appropriate solutions.

  • Collaborating with cross-functional teams (PBM Relations team, Legal, Compliance, Analytics, Customer Service, Sales, McK Distribution, Credit and more) to implement enhanced security protocols and ensure adherence to policies and procedures across CPH, MHS, MID/USON, SNA and RxO customer touchpoints. This individual also provides training and updates to help our internal partners develop skills in risk analysis and mitigation and assists the team in identifying potential risk factors in their day-to-day work with pharmacies.
  • Building strong relationships with PBMs/payers to ensure accurate claims processing and reimbursement. By maintaining open lines of communication, potential risks and issues can be identified and addressed proactively, reducing the likelihood of delays or disputes that could lead to significant financial losses.
  • In addition to working closely with internal teams and payers, this role will partner with various external stakeholders, including Buying Groups, GPOs, regulatory agencies, and legal teams.

  4 – Providing Customer Support and Issue Resolution

  • Conducting timely assessment of significance/impact of potential financial losses, and mitigation of risk associated with these losses. Then weighing the risk against implications to customer and business outcomes, McKesson reputation, and financial / legal risk to reach appropriate decisions.
  • Collaborating with teams across McKesson BUs (CPH, MHS, MID/USON, SNA and RxO) and Functional Areas (Treasury, Credit, Customer Service, Legal) to address complex and sensitive customer issues related to revenue, with ultimate decision responsibility regarding the best approach after considering input from other teams/business areas.

  Minimum Job Qualifications (Knowledge, Skills, & Abilities)

  Education/Training – Degree or equivalent experience

  • 7+ years of professional experience.
  • 4+ years management experience. Degree or equivalent experience.

  Critical Skills/Business Experience

  • 7 years-experience in Process Improvement, Administration Management, Product / Program Management, Management Reporting/MIS, Financial Analysis, Pricing, Controllership, or similar roles.
  • Ability to communicate effectively with senior management.
  • A self-starter and problem solver, persistent and goal oriented.
  • Excellent communication/presentation skills (written, oral), including expertise in Microsoft Word & PowerPoint.
  • Strong collaboration skills as this role manages processes/procedures up and across many BUs/Functional areas.
  • Experience drafting organizational policies/procedures and collaborating with Legal to develop legal documents.
  • Exceptional organizational and workflow/process design skills, including intermediate or higher Visio knowledge.
  • Excellent organizational project management skills, ability to manage multiple projects to achieve desired results within established time frames.
  • Knowledge of Six Sigma and Lean Processes.
  • Good understanding of financial principles, cost accounting, and payment processing related to pharmaceutical claims reimbursements and payment consolidation.

  Specialized Knowledge/Skills

  • Master’s degree in Hospital/Health Administration, Business Administration, Organizational Leadership, Finance, Process Improvement, or another related field, preferred.
  • Exceptional analytical/quantitative skills.
  • Data science and analysis.
  • Expertise in MS Office--Excel, Word, PowerPoint, Visio; SAP; JIRA; Smartsheet; SQL database and queries.
  • Experience at an intermediate-level or higher DocuSign, including complex DocuSign processes and reporting.

  Working Conditions

  • Able to travel overnight domestically 5% of the time.
  • Hybrid Work Environment – Dallas, TX, or Columbus, OH.
  • Must be authorized to work in the US unrestricted – This position is not eligible for sponsorship.

  At McKesson, we care about the well-being of the patients and communities we serve, and that starts with caring for our people. That’s why we have a Total Rewards package that includes comprehensive benefits to support physical, mental, and financial well-being . Our Total Rewards offerings serve the different needs of our diverse employee population and ensure they are the healthiest versions of themselves. For more information regarding benefits at McKesson, please click here.

  As part of Total Rewards, we are proud to offer a competitive compensation package at McKesson. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered.

  Our Base Pay Range for this position

  $94,100 - $156,900

  McKesson is an Equal Opportunity/Affirmative Action employer.

  All qualified applicants will receive consideration for employment without regard to race, color, religion, creed, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.Qualified applicants will not be disqualified from consideration for employment based upon criminal history.

  McKesson is committed to being an Equal Employment Opportunity Employer and offers opportunities to all job seekers including job seekers with disabilities. If you need a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to Disability_Accommodation@McKesson.com . Resumes or CVs submitted to this email box will not be accepted.

  Current employees must apply through the internal career site.

  Join us at McKesson!

• About the company

  McKesson Corporation is an American company distributing pharmaceuticals and providing health information technology, medical supplies, and care management tools.

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