Senior Pharmacy Reimbursement Analyst

Beth Israel Lahey Health • Westwood, MA

4d • $72,000 - $96,000

About The Position

The Pharmacy Reimbursement Analyst supports the financial performance of a large health system pharmacy enterprise under the direction of the Manager, Pharmacy Reimbursement. The role analyzes reimbursement, billing, revenue cycle operations, and payer performance across specialty pharmacy, infusion, retail, and provider-administered drug services. It partners with Pharmacy Operations, Finance, and Information Systems teams to optimize reimbursement, ensure revenue integrity, and identify revenue enhancement opportunities.

Requirements

• Bachelor's degree in Finance, Business, Healthcare Administration, Pharmacy Administration, or a related field.
• 3+ years of healthcare revenue cycle, pharmacy finance, specialty pharmacy, infusion reimbursement, or healthcare analytics experience.
• Advanced Excel and data analytics skills, with the ability to translate complex data into actionable insights.
• Strong analytical, organizational, problem-solving, and project management skills.
• Demonstrated ability to manage multiple priorities while maintaining attention to detail and accuracy.

Responsibilities

• Analyze pharmacy reimbursement, denials, underpayments, and accounts receivable trends to identify revenue recovery and optimization opportunities.
• Perform analytics, rebate reconciliation, dispute management, and financial performance reporting.
• Analyze 340B and MFP rebate eligibility, reimbursement, and payment variances within pharmacy systems; prepare and submit appeals and disputes to manufacturers, payers, and third-party administrators to ensure accurate rebate capture and revenue recovery.
• Investigate payer denials and underpayments, prepare appeals, and coordinate resolution with payers and internal stakeholders.
• Support medication charge capture, reimbursement integrity, and pharmacy revenue cycle process improvements.
• Develop dashboards and reports tracking reimbursement performance, denials, rebates, payer trends, and key pharmacy financial indicators.
• Collaborate with pharmacy leadership, finance, contracting, and revenue cycle teams to improve operational and financial outcomes.
• Stay current on pharmacy reimbursement regulations, payer policies, 340B requirements, and Medicare reimbursement changes.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior