Margin Specialist / Remote

Amerita•Centennial, CO

1d•$55,000 - $60,000•Remote

About The Position

The Margin Optimization Specialist will be a part of the Margin Optimization team, responsible for reviewing internal performance and service improvement efforts by using superior analytical skills and logic to analyze business problems, develop solutions, and present recommendations to senior leadership. They will also ensure that approved proposals are implemented, and yield promoted value. This position involves reviewing margins for all dispenses to drive optimal margins. They will apply their knowledge and experience to reviewing the data and submitting their findings to the margin team management for a secondary review. This position is responsible for engaging the sales team to convert medications to clinically approved substitutes. They will identify areas for conversion opportunities and track their process in converting each patient.

Requirements

Bachelor’s degree or equivalent pharmacy experience.
Licensed as a certified pharmacy technician desired
3 + years in the pharmacy field with Infusion Pharmacy focus.
7+ years’ experience in working in a professional services environment with internal client / stakeholder management, analytical skills, and issue resolution / management desired
Superior analytical skills, self-motivation, detail oriented, quantitative skills, logic, and problem-solving skills, PBM billing experience.
Medical billing experience desired
Ability to travel up to 10%

Responsibilities

Reports directly to the Margin Optimization Director
Provide support for the infusion dispensing and fulfillment operations across the pharmacy network. They will engage in business improvement and sustainability, cost reduction projects and process flow optimization
Collaborate with internal and external operational, business and technical teams in the process of managing activities associated with balancing volumes in multiple facilities and maximizing profitability
Responsible for the hourly oversight of the negative margin process to ensure the business maintains a healthy probability
Make decisions to approve or deny each claim that is reviewed accurately
Audit previous approvals to ensure losses are appropriate and the reimbursement is up to date
Identify product substitution opportunities to enhance probability and minimize copay costs to patients
Ensure regular compliance to state licensure regulations to governmental standards
Conduct analysis and consult business leadership and partners on findings and insights. Present and communicate findings to recommend changes to the margin team
Identify problem areas with effective follow-through to quickly address the root causes and coordinate activities with cross functional team members from Operations, IT, Finance and Procurement/Corporate Inventory