Sr Pharmacy Analyst

The primary focus of the position is to support the operational efficiency of the Pharmacy Department by coordinating fiscal management activities, performing data analysis and maintaining departmental statistics and reports. Data base development, project management, cost accounting, and IT skills will be employed to work with clinical pharmacists, residents, medical staff, and pharmacy administration.

MINIMUM QUALIFICATIONS :

EDUCATION, EXPERIENCE, CERTIFICATION, AND / OR LICENSURE :

1. Bachelor degree in Information Technology, Business Management, Hospital Administration, Accounting, or Finance.  AND Five (5) years of experience in pharmacy or Three (3) years of experience with financial reporting.

PREFERRED QUALIFICATIONS :

EDUCATION, CERTIFICATION, AND / OR LICENSURE :

1. Certified Revenue Cycle Representative (CRCR).

2. Certified Healthcare Financial Professional (CHFP).

3. Certified Specialist Business Intelligence (CSBI).

EXPERIENCE :

1. Direct experience in data analysis and / or health care planning background.

CORE DUTIES AND RESPONSIBILITIES : The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1. Advises and educates staff when billing procedures performed by the department are not accurate or timely.

2. Coordinates with Patient Financial Services to review underpayments or denials.

3. Assures charges governed by APC’s are handled correctly.

4. Coordinates all major changes and updates for Chargemaster & other pharmacy EPIC platforms.

5. Assures utilization of all available indigent care programs for inpatient and outpatient administration of medications.

6. Coordinates with Clinical Specialists to evaluate practice change opportunities that would allow inpatient medication administration to be switched to outpatient medication administration.

7. Assists pharmacy management in implementation of identified inventory and automation opportunities.

8. Facilitates contract negotiations with manufacturers for best pricing and availability of product.

9. Coordinates with Premier (GPO) and Amerisource Bergen to assist with contract compliance and identify savings opportunities that we are not taking advantage of at this time. Relay those items to Pharmacy Manager & Inventory Buyer to implement changes when possible.

10. Assists pharmacy management with annual budget forecasting.

11. Generates a year-end report of budget versus expended dollars based on reconciliation of budget with the general ledger, for each cost center by account.

12. Compiles data, profiles comparisons, and generates reports related to current expenses to serve as the basis for the asking budget.

13. Provides scheduled and ad hoc reports as needed to all levels of staff, management, and external agencies.

14. Generates pharmacy spend advisor reports on a monthly basis to ensure that we are purchasing pharmaceuticals in the most cost efficient manner. Communicate those opportunities to Pharmacy Manager & Buyers. Follow up to assist with implementation of changes.

15. Collaborates with accounting and finance to reconcile any expenditure discrepancies.

16. Reconciles department current expenditure documentation with the hospital general ledger and rectifies errors within 30 days.

17. Identifies irregular spending and system failures related to current expense activity, develops plan to rectify, and reports to department Director.

18. Interacts with various hospital departments responsively and productively to promote efficient systems interface and problem resolution related to technological, fiscal, and clinical management as deemed necessary by management

19. Interacts regularly with the department management team and clinical specialists to supply drug usage information, identify irregularities in spending, and provide recommendations for alternative products.

20. Supports Pharmacy, Nutrition and Therapeutics Committee functions by providing financial data to be used in the drug evaluation process, including opportunities for therapeutic interchange of medications.

21. Participates in select formulary subcommittees as an active member for financial reviews.

22. Works with department management in the development and implementation of departmental goals and objectives.

23. Participates in the planning and implementation of change and maintaining the improving productivity through attendance and participation in staff meetings, committees, task forces and projects.

24. Participates in the education of other health-care professionals as it pertains to appropriate use and billing of medications.

25. Reviews and evaluates potential software opportunities.

26. Develops policies and procedures.

27. Routinely reviews system databases for accuracy in the drug formulary or product specifications.

28. Assures appropriate safeguards and system integrity.

29. Facilitates communication with insurances regarding policies and medication or specific patient coverage.

30. Coordinates researching departmental issues and involves proper information technology, contracting, or finance personnel to resolve issues as needed.

31. Demonstrates ability to lead a team on projects and the resolution of problems to include obtaining all necessary data and documentation needed.

32. Collaborates with Denials Management & Revenue Integrity teams around medication denials and underpayments including appeals based on medical necessity as needed.

33. Maintains positive working relationships with external vendors such as manufacturers, insurance carriers, government agencies, and insurance provider representatives.

34. Coordinates all pharmacy informatics related implementations and maintenance as needed.

PHYSICAL REQUIREMENTS : The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. While performing the duties of this position, the employee is required to walk and stand for long periods of time.

2. Must be able to lift 30 pounds and must be able to push 50 pounds.

3. Dexterity required to finger, handle, and reach.

SKILLS AND ABILITIES :

1. Extensive working knowledge of Microsoft Office applications Excel & Access.