PHARMACY BUSINESS ANALYST (1.0)

Billings Clinic-posted about 2 months ago
$28 - $35/Yr
Full-time • Mid Level
Remote • Billings, MT
Hospitals
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You'll want to join Billings Clinic for our outstanding quality of care, exciting environment, interesting cases from a vast geography, advanced technology and educational opportunities. We are in the top 1% of hospitals internationally for receiving Magnet Recognition consecutively since 2006. And you'll want to stay at Billings Clinic for the amazing teamwork, caring atmosphere, and a culture that values kindness, safety and courage. This is an incredible place to learn and grow. Billings, Montana, is a friendly, college community in the Rocky Mountains with great schools and abundant family activities. Amazing outdoor recreation is just minutes from home. Four seasons of sunshine! You can make a difference here. About Us Billings Clinic is a community-owned, not-for-profit, Physician-led health system based in Billings with more than 4,700 employees, including over 550 physicians and non-physician providers. Our integrated organization consists of a multi-specialty group practice and a 304-bed hospital. Learn more about Billings Clinic (our organization, history, mission, leadership and regional locations) and how we are recognized nationally for our exceptional quality. Your Benefits We provide a comprehensive and competitive benefits package to all full- and part-time employees (minimum of 20 hours/week), including Medical, Dental, Vision, 403(b) Retirement Plan with employer matching, Defined Contribution Pension Plan, Paid Time Off, employee wellness program, and much more. Click here for more information or download the Employee Benefits Guide. Magnet: Commitment to Nursing Excellence Billings Clinic is proud to be recognized for nursing excellence as a Magnet-designated organization, joining only 97 other organizations worldwide that have achieved this honor four times. The re-designation process happens every four years. Click here to learn more! Pre-Employment Requirements All new employees must complete several pre-employment requirements prior to starting. Click here to learn more! PHARMACY BUSINESS ANALYST (1.0) SPECIALTY PHARMACY (Billings Clinic Main Campus) req10865 Shift: Fully Remote Employment Status: Full-Time (.75 or greater) Hours per Pay Period: 1.00 = 80 hours every two weeks (Exempt) Starting Wage DOE: $27.69 - 34.61 Job may be remote within the US or a hybrid role for someone in the Billings area. Works effectively with Pharmacy Leadership Team, Information Technology, and Finance Departments to plan, organize, facilitate and monitor the activities and functions of the pharmacy financial operations. The Pharmacy Business Analyst will be responsible to provide the financial leadership and direction for the assigned pharmacy division(s), including inpatient and outpatient, to ensure continuity and consistency across and throughout departments and in the region. Ensures the delivery of cost effective health care services in line with the Billings Clinic mission, vision, values and goals. Accountabilities include strategic financial planning and new program development directly related to the Pharmacy Department, fiscal control and responsibility to manage revenue and costs, and financial process improvement.

  • Supports and models behaviors consistent with Billings Clinic's mission, vision, values, code of business conduct and service expectations. Meets all mandatory organizational and departmental requirements. Maintains competency in all organizational, departmental and outside agency standards as it relates to the environment, employee, patient safety or job performance.
  • Understands the overall workflow to proactively solve problems, provide analysis, and evaluate trends in the revenue cycle. Displays initiative to resolve 835 remittance issues including, but not limited to: unapplied cash, claim exceptions, and partial pays. Provide claims resolution to ensure accuracy in the process.
  • Assists with inventory, supply and equipment acquisition and repair, and vendor relations.
  • Conducts performance and payment audits for both internal and external audits. Supervises the collection of payment data and provides recommendations and resolution to audit results. Attends, reviews, researches, and responds to payer audits. Develops audit responses and correspondences with payer and escalates adverse audits to management.
  • Provides proactive and ongoing follow-up and problem solving with insurance companies and pharmacy sites to identify trends, communicate proactively, and ensure accuracy in the revenue cycle process.
  • Ensures optimal revenue cycle performance through evaluation, analysis, and problem solving. Provides analysis to stakeholders and constantly analyzes operations in an attempt to improve processes in order to provide better customer service and improve the revenue cycle.
  • Reviews payments for accuracy, ensure collection according to contracts, and follows-up with insurance companies to leverage the revenue process.
  • Oversees the creation of analysis consisting of proformas, IRR's, capital requests, and business line opportunities.
  • Collect and analyze data for fiscal impact of existing and proposed contracts, business lines, and product lines for both internal and external customers. Provide analysis, recommendations, and summary to stakeholders
  • Understands contracts to achieve results and department metrics, including but not limited to: payer DSO equal or exceeds department goals, A/R percentage over 60 days equals or exceeds department goals, and timely submission of secondary payer billings equals or exceeds department goals.
  • Maintains competency in all organizational, departmental and outside agency environmental, employee or patient safety standards relevant to job performance.
  • Performs other duties as assigned or needed to meet the needs of the department/organization.
  • Bachelor's degree in business, economics, or other related field
  • Three (3) years' experience in business operations and financial process improvement
  • Or an equivalent combination of education and experience relating to the above tasks, knowledge, skills and abilities will be considered. Employees that require a licensed or certification must be properly licensed/certified and the licensure/certification must be in good standing.
  • Master's degree in business or healthcare administration, preferred
  • Prior healthcare experience, preferred
  • Medical
  • Dental
  • Vision
  • 403(b) Retirement Plan with employer matching
  • Defined Contribution Pension Plan
  • Paid Time Off
  • employee wellness program
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