Clinical Pharmacist-RCM and Contracts

Value Apothecaries

286d • Hybrid

About The Position

We are seeking a highly motivated and detail-oriented Pharmacist to join our team in a specialized role focused on Revenue Cycle Management (RCM) and Medication Contracting. This position is responsible for optimizing medication reimbursement, managing payer policies, ensuring compliance with contractual terms, and supporting formulary strategies to enhance financial performance across pharmacy operations.

Requirements

• PharmD or equivalent degree from an accredited school of pharmacy.
• Active pharmacist license in TN, or eligible for licensure.
• Minimum 3-5 years of experience in health system pharmacy, managed care, or pharmacy benefit management.
• Strong understanding of healthcare reimbursement models, payer policy, and pharmaceutical contracting.
• Familiarity with 340B, GPO contracting, CMS billing regulations, and drug pricing standards.
• Excellent analytical, communication, and cross-functional collaboration skills.

Nice To Haves

• PGY-1 Residency and/or advanced training in pharmacy administration, health economics, or business (e.g., MBA, MHA).
• Experience with Cerner.
• Experience working with specialty or infusion pharmacy services.

Responsibilities

• Lead pharmacy initiatives in revenue cycle optimization including billing practices, charge capture, and denial management.
• Collaborate with finance, compliance, and clinical teams to ensure accurate and efficient medication reimbursement processes.
• Interpret payer contracts and develop strategies to ensure compliance with medication-related terms and maximize reimbursement.
• Analyze utilization trends, reimbursement data, and drug pricing benchmarks (e.g., WAC, AWP, ASP) to support cost containment.
• Support 340B program compliance and optimization where applicable.
• Assist in the negotiation and maintenance of medication purchasing and payer contracts.
• Monitor regulatory changes affecting medication billing and reimbursement.
• Provide guidance and education to clinical and operational teams on revenue cycle and contracting processes.

Benefits

• Medical, dental, and vision care.
• Backup dependent care.
• Adoption assistance.
• Infertility coverage.
• Family building support.
• Behavioral health solutions.
• Paid parental leave.
• Paid caregiver leave.
• Training programs.
• Professional development resources.
• Opportunities to participate in mentorship programs, employee resource groups, and volunteer activities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Chemical Manufacturing
• Education Level: Ph.D. or professional degree