Pharmacy Business & Analytics Specialist
About The Position
We have an exciting opportunity to join our team as a Pharmacy Business & Analytics Coordinator. As part of the Pharmacy Business & Analytics (PBA) team, this position monitors and manages Third Party Administrator (TPA) split-billing software reports to ensure regulatory compliance and optimization of 340B Program revenue. Of paramount focus will be responsibly monitoring for diversion and 340B, GPO, and WAC pricing integrity. Manages formulary matrix performance reporting and responds to alerts to perform drug mapping, execute on penny buys, and maintain processes for revenue-integrity analytics. Other key areas of focus include conversion factor maintenance, file extractions & connectivity (ongoing support), IT/Epic/Willow support, general reporting and monitoring, compliance (GPO Prohibition), reimbursement and cost report collaboration, assessing current and future opportunities, and inventory maintenance and monitoring. Additionally, this position will assist with the monitoring and management of contract pharmacy operations, writing PBA/340B policies and procedures, education and training, and Office of Pharmacy Affairs Information System (OPAIS) ongoing maintenance.
Requirements
- Bachelors degree in Pharmacy
- 3+ years of experience
- 340B Apexus Certified Expert (340B ACE) Certification within six months of hire
- New York State Pharmacist License required
- Qualified candidates must be able to effectively communicate with all levels of the organization.
Nice To Haves
- Doctor of Pharmacy (PharmD)
- 340B ACE Certification
- Pharmacy IT experience
- Informatics degree or certificate
- Strong Microsoft Excel skills with experience in Tableau, Power BI, and other data analytic/visualization platforms
- Prior experience with implementation of Epic
- Knowledge of Six Sigma
Responsibilities
- Maintain pharmacy acquisition, WAC and 340B costs and assists in charge configuration reviews with revenue cycle and Willow teams. This will require routine consult with the pharmacy purchasing staff and the pharmacy drug wholesaler to ensure accurate pricing and purchase unit configuration in all related electronic billing systems.
- Investigates and resolves 340B, GPO, and WAC pricing discrepancies with drug wholesalers and further pursues resolution with other resources as necessary.
- Ensures compliance with all regulatory standards for 340B Program.
- Monitors for potential drug supply chain issues, wastage and shrinkage, revenue integrity, billing, and mismatches between clinical and financial charge databases.
- Utilizes the TPA to identify and optimize revenue opportunities by executing orders for Penny Buys (340B).
- Performs billing quality assurance (QA) before and after price uploads, as well as when new medications are approved by the Pharmacy and Therapeutics Committee (P&T).
- Assists and supports pharmacy drug file maintenance.
- Supports related pharmacy applications (Electronic Health Record, automation technology, etc.) including, but not limited to, system upgrade and maintenance, which may require working during off hours.
- Prepares system generated report to support pharmacy operations and is available for system troubleshooting and downtimes.
- Supports the auditing process required for program compliance and reporting.
- Assists and supports employee training for systems utilization and adaptation.
- Supports a non-punitive reporting approach when medication variances are identified as due to an individual/group involvement.
- Provides tools and coaching sessions, when necessary, to establish an environment for improvement.
- Act as a liaison to the TPA, other vendors, consultants, and pharmacy.
- Attends meetings as required.
- Serves as a member of the pharmacy departments leadership team. Supports an environment dedicated to the safety of our patients and staff and facilitate a perpetual efficiency-improvement process in the medication-use physical environment.
- Precepts pharmacy students and residents if so assigned.
- Collaborates with Risk Management, Compliance, and QA Departments as necessary.
- Supports other pharmacy functions as needed.
- Participates in scholarly/professional activities.
Benefits
- financial security benefits
- a generous time-off program
- employee resources groups for peer support
- holistic employee wellness program, which focuses on seven key areas of well-being: physical, mental, nutritional, sleep, social, financial, and preventive care.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
