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Posted : Sunday, May 26, 2024 08:59 AM
JOB SUMMARY:
The pharmacy operations analyst is a key member of the pharmacy leadership team, assisting the Director of Pharmacy and the Pharmacy Supervisors in the management of all administrative activities related to pharmaceutical reimbursement, revenue integrity, budgeting and optimization to drive financial improvements.
They will also work closely with the Pharmacy Supervisors to ensure proper audits of narcotics, minimize diversion, proper adherence to repackaging, and monitoring of drug waste.
The analyst functions to optimize processes and procedures, resolve issues, and ensure consistency for all pharmacy departments/entities.
The individual will be responsible for auditing, consolidating and manipulating data, performing cost benefit and trend analysis, and designing and distributing reports to continually improve performance.
The analyst must effectively utilize multiple software systems at on-site locations.
The individual works in a highly regulated environment and must take care to abide by all state and federal regulations that relate to the practice of pharmacy.
MINIMUM QUALIFICATIONS: Education: Bachelor’s degree recommended; Healthcare related field, business management (finance, accounting) or information technology preferred; suitable work experience may substitute.
Experience: 2 to 5 years of professional experience in a healthcare field required 1 to 2 years of Management preferred Excellent verbal and written communication skills required Should have specific knowledge of accounting principles and financial reporting Licensure or Certification: Pharmacy Technician Licensure by the State of OH required Skills: Shall possess the personal characteristics necessary for successfully fulfilling his/her responsibilities.
These characteristics include excellent verbal and written communication skills, initiative, flexibility, time management, cooperation and attention to detail.
Excellent computer and database skills; highly competent in Microsoft Excel and other Microsoft applications Knowledgeable regarding analyzing and reporting data in order to identify issues, trends, or exceptions to drive improvement of results and find solutions Must be able to effectively navigate multiple vendor-based internet software applications and have previous experience with databases.
Shall be able to work independently and with the pharmacy team to develop best practices and goals to optimize pharmacy operations.
ESSENTIAL FUNCTIONS: Perform drug expense analysis Coordinate with clinical service lines to perform service line profitability Develop monthly and yearly projections Assist with pharmacy financial database maintenance and updates Work with the Director of Pharmacy and Pharmacy Operations Manager/Supervisors to implement and monitor pharmacy inventory goals and objectives Collaborate with revenue integrity, finance, and others to optimize medication reimbursement outcomes Research program availability and patient requirements to optimize patient access to programs such as Pharmaceutical Assistance programs (PAP), bulk replacement programs, assistance grants, etc.
Effectively manage a patient tracking database to track patient assistance applications, approvals, receipt of medication, dispensing, billing, and compliance Report ongoing key financial and compliance metrics to finance and pharmacy leadership teams to ensure desired outcomes are being achieved Coordinate patient care by educating and working closely with physicians, case managers, business personnel, nurse practitioners, clinic personnel, etc.
, with specialty drugs and provide feedback regarding compliance with referrals, formulary, and documentation Develop policies and procedures as applicable to patient assistance Oversee the patient assistance process and maintain records of program assistance, compile and submit financial reports to committees, and perform required audits Coordinate implementation of new patient assistance programs, including submission of required applications, development of policies and procedures, and affiliation agreements/contracts Perform drug reimbursement analysis; develop and analyze reports that allow root cause analysis on unpaid/underpaid accounts tracking loss, recovery, and margin over time Assist Market Director of Pharmacy and key stakeholders in developing strategies to minimize financial risks associated with outpatient medication reimbursement Report ongoing key financial metrics to finance and pharmacy leadership teams to ensure desired targets are achieved Work closely with Case Management and patients to identify opportunities to minimize financial risk for uninsured and underinsured patients requiring outpatient infusion services.
Analyze internal processes, technical system issues and payer processing/system issues that contribute to revenue capture opportunities.
Stay abreast of payer and government policy changes that may impact current standard operations, strategize accordingly Document appeals of payment variances and reimbursement amounts recovered through the various appeals processes.
Identify and communicate corrective actions in order to resolve payment variances Perform special projects, as assigned, in order to identify and resolve recovery issues and/or avert loss Audit Narcotics through EMAR and Pyxis systems, and report as defined by CSH Standards and drive daily review of discrepancies Coordinate or conduct audits of controlled substances as defined by CSH standards Coordinate pharmacy repackaging standards and optimize drug waste Maintain all records and documents in accordance with state and federal regulations Other duties as assigned by management Location: Trinity Health System · TMW PHARMACY Schedule: Full Time, Days, M-F
They will also work closely with the Pharmacy Supervisors to ensure proper audits of narcotics, minimize diversion, proper adherence to repackaging, and monitoring of drug waste.
The analyst functions to optimize processes and procedures, resolve issues, and ensure consistency for all pharmacy departments/entities.
The individual will be responsible for auditing, consolidating and manipulating data, performing cost benefit and trend analysis, and designing and distributing reports to continually improve performance.
The analyst must effectively utilize multiple software systems at on-site locations.
The individual works in a highly regulated environment and must take care to abide by all state and federal regulations that relate to the practice of pharmacy.
MINIMUM QUALIFICATIONS: Education: Bachelor’s degree recommended; Healthcare related field, business management (finance, accounting) or information technology preferred; suitable work experience may substitute.
Experience: 2 to 5 years of professional experience in a healthcare field required 1 to 2 years of Management preferred Excellent verbal and written communication skills required Should have specific knowledge of accounting principles and financial reporting Licensure or Certification: Pharmacy Technician Licensure by the State of OH required Skills: Shall possess the personal characteristics necessary for successfully fulfilling his/her responsibilities.
These characteristics include excellent verbal and written communication skills, initiative, flexibility, time management, cooperation and attention to detail.
Excellent computer and database skills; highly competent in Microsoft Excel and other Microsoft applications Knowledgeable regarding analyzing and reporting data in order to identify issues, trends, or exceptions to drive improvement of results and find solutions Must be able to effectively navigate multiple vendor-based internet software applications and have previous experience with databases.
Shall be able to work independently and with the pharmacy team to develop best practices and goals to optimize pharmacy operations.
ESSENTIAL FUNCTIONS: Perform drug expense analysis Coordinate with clinical service lines to perform service line profitability Develop monthly and yearly projections Assist with pharmacy financial database maintenance and updates Work with the Director of Pharmacy and Pharmacy Operations Manager/Supervisors to implement and monitor pharmacy inventory goals and objectives Collaborate with revenue integrity, finance, and others to optimize medication reimbursement outcomes Research program availability and patient requirements to optimize patient access to programs such as Pharmaceutical Assistance programs (PAP), bulk replacement programs, assistance grants, etc.
Effectively manage a patient tracking database to track patient assistance applications, approvals, receipt of medication, dispensing, billing, and compliance Report ongoing key financial and compliance metrics to finance and pharmacy leadership teams to ensure desired outcomes are being achieved Coordinate patient care by educating and working closely with physicians, case managers, business personnel, nurse practitioners, clinic personnel, etc.
, with specialty drugs and provide feedback regarding compliance with referrals, formulary, and documentation Develop policies and procedures as applicable to patient assistance Oversee the patient assistance process and maintain records of program assistance, compile and submit financial reports to committees, and perform required audits Coordinate implementation of new patient assistance programs, including submission of required applications, development of policies and procedures, and affiliation agreements/contracts Perform drug reimbursement analysis; develop and analyze reports that allow root cause analysis on unpaid/underpaid accounts tracking loss, recovery, and margin over time Assist Market Director of Pharmacy and key stakeholders in developing strategies to minimize financial risks associated with outpatient medication reimbursement Report ongoing key financial metrics to finance and pharmacy leadership teams to ensure desired targets are achieved Work closely with Case Management and patients to identify opportunities to minimize financial risk for uninsured and underinsured patients requiring outpatient infusion services.
Analyze internal processes, technical system issues and payer processing/system issues that contribute to revenue capture opportunities.
Stay abreast of payer and government policy changes that may impact current standard operations, strategize accordingly Document appeals of payment variances and reimbursement amounts recovered through the various appeals processes.
Identify and communicate corrective actions in order to resolve payment variances Perform special projects, as assigned, in order to identify and resolve recovery issues and/or avert loss Audit Narcotics through EMAR and Pyxis systems, and report as defined by CSH Standards and drive daily review of discrepancies Coordinate or conduct audits of controlled substances as defined by CSH standards Coordinate pharmacy repackaging standards and optimize drug waste Maintain all records and documents in accordance with state and federal regulations Other duties as assigned by management Location: Trinity Health System · TMW PHARMACY Schedule: Full Time, Days, M-F
• Phone : NA
• Location : 4000 Johnson Rd, Steubenville, OH
• Post ID: 9004016261
