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Risk Management Analyst

Risk Management Analyst

Columbus StaffingColumbus, OH, US
1 day ago
Job type
  • Full-time
Job description

McKesson Analyst Role

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
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    Risk Management Analyst • Columbus, OH, US

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