Anyone have experience in Managed Care?

Started by kvl1027
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kvl1027

kvl1027

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15+ Year Member
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Hello, Looking at the possiblity of working in managed care in the near future. Wellcare is hiring near me and I have business idea, in which some experience in managed care could be very useful. I'm a little concerned about working for the "darkside", perhaps someone could shed some light on what it's like.
 
kvl1027 said:
Hello, Looking at the possiblity of working in managed care in the near future. Wellcare is hiring near me and I have business idea, in which some experience in managed care could be very useful. I'm a little concerned about working for the "darkside", perhaps someone could shed some light on what it's like.
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I have a friend who works for a big MCO in Minnesota and he seems to like it a lot. Compared to most of his pharmacist friends, his lifestyle is good. No weekends, regular hours, and takes a lunch as long as he wants.

Problem is...is this a good career path? Hospital pharmacists are being laid off and retail is retail...what do you guys think?
 
Having manage care experience will definitely help you to land a good position at PBM later. Most ads I see require 5 years of manage care experience or insurance experience. I think it is a better career pathway than retail or hospital. Another good field to get in is pharmacoecomonics.
 
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kvl1027 said:
Hello, Looking at the possiblity of working in managed care in the near future. Wellcare is hiring near me and I have business idea, in which some experience in managed care could be very useful. I'm a little concerned about working for the "darkside", perhaps someone could shed some light on what it's like.
Click to expand...
wellcare is going to hire you because you have a great business idea?
 
Recently got a job at one of the top 4 in the country..Only been there a couple of weeks and I feel more job security than I had when I was in retail
 
GodsSon2011 said:
Recently got a job at one of the top 4 in the country..Only been there a couple of weeks and I feel more job security than I had when I was in retail
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How do you get one without a residency or fellowship these days? Is it still possible? Anyone with experience care to chime in...I know it's kinda a stupid question ("just apply anyway")
 
5minutes said:
Having manage care experience will definitely help you to land a good position at PBM later. Most ads I see require 5 years of manage care experience or insurance experience. I think it is a better career pathway than retail or hospital. Another good field to get in is pharmacoecomonics.
Click to expand...

Why is PBM a better career pathway than hospitals/retail?
 
I am curious. As an intern, where can you get managed care related experience? I believe there's a 6 week rotation available in 4th year but at that point, it may be too late right?
 
positivesign said:
I am curious. As an intern, where can you get managed care related experience? I believe there's a 6 week rotation available in 4th year but at that point, it may be too late right?
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PBMs do hire technicians, but I think you'd need availability during normal business hours.
 
Lnsean said:
How do you get one without a residency or fellowship these days? Is it still possible? Anyone with experience care to chime in...I know it's kinda a stupid question ("just apply anyway")
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personality personality personality

its in a office setting. People don't want to work with weirdos
 
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Look, of course people get in without any experience or without a residency into managed care, it's like anything in life. What we can say for sure is that if you do a managed care residency, the chances are high you work in that field.

And yes MC is better than inpatient, that is if you like that kind of work, mainly desk work doing projects, going to meetings. If you're in the PA dept, that's another story.
 
It's pretty difficult to get a mc position without a residency; I got lucky

The work can be demanding but no weekend, no holiday and you will be working with people with a lot of experience

The drawback is that they may move your job to another state lol
 
moolman said:
Look, of course people get in without any experience or without a residency into managed care, it's like anything in life. What we can say for sure is that if you do a managed care residency, the chances are high you work in that field.

And yes MC is better than inpatient, that is if you like that kind of work, mainly desk work doing projects, going to meetings. If you're in the PA dept, that's another story.
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What kind of personality traits are common to pharmacists in managed care? Are they less good with patients (bad communicators) since they are not in retail?
 
OSU2017 said:
What kind of personality traits are common to pharmacists in managed care? Are they less good with patients (bad communicators) since they are not in retail?
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Not from what I've seen. The ones I've met are great communicators, and a lot of fun.
 
OSU2017 said:
What kind of personality traits are common to pharmacists in managed care? Are they less good with patients (bad communicators) since they are not in retail?
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You probably a better personality or disposition than hospital or retail. In this environment you have to work with these pharmacist everyday and see them all the time in meetings and the desk next to you. If you're an awkward person in retail, who cares, you have the shift to yourself or in the hospital, just stick you in the IV room by yourself. 😀

Realistically, it's more about the training, do the things you need to do to get into the field, a residency helps the most or you just get lucky just like any other job.
 
positivesign said:
I am curious. As an intern, where can you get managed care related experience? I believe there's a 6 week rotation available in 4th year but at that point, it may be too late right?
Click to expand...

If your school has an AMCP chapter then participate in the P&T Competition.

FMCP & Pfizer sponsor summer internship programs at various MCOs across the country. Other MCOs offer their own unique summer internships too (i.e. Express Scripts, Cigna, etc.)

Worst-case, find a faculty member who does cost effectiveness analysis or health outcomes research and see if you find their line of work interesting.

And of course landing a rotation in a managed care setting would be beneficial.
 
My first experience in managed care was through a rotation, never did AMCP anything, then I applied to residencies and my sunny personality must of won them over...lol
 
I currently work in both hospital and retail. I did have a drug information rotation at a PBM/Mailorder facility that dispensed only specialty medications. I spent a good amount of time working in prior authorizations and compliance. Is this enough experience?
 
moolman said:
My first experience in managed care was through a rotation, never did AMCP anything, then I applied to residencies and my sunny personality must of won them over...lol
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What kind of responsibilities do you have with your current managed care job? Trying to see how it may differ than retail or hospital...any info would be wonderful.
 
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