Pharmacy Support Analyst

Hennepin Healthcare is an integrated system of care that includes HCMC, a nationally recognized Level I Adult Trauma Center and Level I Pediatric Trauma Center and acute care hospital, as well as a clinic system with primary care clinics located in Minneapolis and across Hennepin County. The comprehensive healthcare system includes a 473-bed academic medical center, a large outpatient Clinic & Specialty Center, and a network of clinics in the North Loop, Whittier, and East Lake Street neighborhoods of Minneapolis, and in the suburban communities of Brooklyn Park, Golden Valley, Richfield, and St. Anthony Village. Hennepin Healthcare has a large psychiatric program, home care, and operates a research institute, philanthropic foundation, and Hennepin EMS. The system is operated by Hennepin Healthcare System, Inc., a subsidiary corporation of Hennepin County.

Equal Employment Opportunities: We believe equity is essential for optimal health outcomes and are committed to achieve optimal health for all by actively eliminating barriers due to racism, poverty, gender identity, and other determinants of health. We are committed to equitable care and working in an environment that celebrates, promotes, and protects diversity, equity, inclusion, and belonging. We are committed to bringing in individuals with new cultural perspectives to assist in creating a more equitable healthcare organization.

SUMMARY:

We are currently seeking a Pharmacy Support Analyst to join our Hospital Admin Pharmacy team. This position is part-time with benefits, 40 hours per pay period, day shift, Monday – Friday, 8 hr shifts.

Work Location: Positive Care Clinic

Purpose of this position: Under the direct supervision, is responsible for providing coordination, clarification, and communication of all financial aspects of pharmacy, including insurance and authorization verification, claims research, patient assistance, and formulary management. This role will also be used in a patient facing capacity to evaluate, assist, and support patients who are un-insured or under insured in navigating billing aspects associated with their care in Positive Care Clinic.In addition, the individual will support the Pharmacy department by leading projects and developing processes needed for day-to-day business activities

RESPONSIBILITIES:

• Verifies insurance coverage and obtains authorizations and certifications for the patient’s medication treatment. Obtains all necessary signatures and documentation required by the patient’s third party payer. Accurately and completely documents all information into EPIC to ensure maximum reimbursement. Monitors and updates information regarding insurance data, authorizations, and preferred providers. Partners with the clinical care team and insurance provider to ensure continued coverage of patient’s care and maximum reimbursement and minimized financial impact to the patient
• Provides financial advocacy, assistance, and support to patients and families, as needed. Assists patients who are un-insured or under insured to access other funding resources and completes required documents. Maintains current working knowledge of Medicare, Medicaid, and other program benefits and criteria, particularly as they pertain to pharmacy benefits. Serves as a liaison between the facility and community/manufacturers in making patient assistance resources available to the patient and family
• Acts as a liaison between patient/hospital/provider/payer to enhance account receivables performance, resolves outstanding issues and/or patient concerns, and maximizes service excellence. Monitors pharmacy claim data and EPIC work queues to identify critical reimbursement issues and works with Finance and Billing to resolve them in an expedient and proactive manner. Understands charge master set up and maintenance requirements
• Works with Pharmacy leadership on internal audits and external audits from 3rd party payors and government agencies, including but not limited to Medicaid and Medicare
• Obtains knowledge of payer requirements and policy benefit structure, including Medicare and Medicaid. Keeps current on payer trends and changes utilizing websites, emails, and bulletin communications. Continually reviews and monitors billing and coding changes affecting Pharmacy
• May work directly with providers to obtain prior authorizations for medications
• Provides leadership and training to other members of the team and serves as a resource for internal and external customers
• Other duties as assigned

QUALIFICATIONS:
Minimum Qualifications:

• Associate’s Degree, with a focus on healthcare or finance
• 3 year’s professional experience working in pharmacy business office, payer business office, or equivalent area

-OR-

• An approved equivalent combination of education and experience

Preferred Qualifications:

• Bachelor’s degree in Business Administration, Health Care Administration, Nursing, Health Information Management, or related healthcare concentration area

Knowledge/ Skills/ Abilities:

• Requires extensive knowledge of government and commercial payer requirements to ensure accurate and compliant charging and billing of medications
• Demonstrated expertise in logical thinking, data preparation, and analysis
• Comprehensive knowledge of Microsoft Office (Outlook, Word, Excel and Access)
• Strong communication skills, both verbal and written
• Knowledge of medical and pharmacy terminology
• Ability to communicate effectively with medical providers

You've made the right choice in considering Hennepin Healthcare for your employment. We offer a wealth of opportunities for individuals who want to make an impact in our patients' lives. We are dedicated to providing Equal Employment Opportunities to both current and prospective employees. We are driven to connect talented individuals with life-changing career opportunities, enabling you to provide exceptional care without exception. Thank you for considering Hennepin Healthcare as a future employer.

Please Note: Offers of employment from Hennepin Healthcare are conditional and contingent upon successful clearance of all background checks and pre-employment requirements.

• We offer a competitive pay rate based on your skills, licensure/certifications, education, experience related to this position, and internal equity.
• We provide an extensive benefits program that includes Medical; Dental; Vision; Life, Short and Long-term Term Disability Insurance; Retirement Funds; Paid Time Off; Tuition reimbursement; and license and Certification reimbursement (Available ONLY for benefit eligible positions).
• For a complete list of our benefits, please visit our career site on why you should work for us.