Associate Pharmacy Analyst

Overview

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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. Direct work with patients and/or insurances may be involved to assist with coordinating information needed to qualify them for coverage or financial assistance.

• Bachelor degree in Information Technology, Business Management, Hospital Administration, Accounting, or Finance.
• OR Associates degree in Information Technology, Business Management, Hospital Administration, Accounting, or Finance and Two (2) years of experience of pharmacy experience or one (1) year of experience with financial reporting.
• OR High School Diploma and Nationally Certified Pharmacy Technician within 15 months of hire and four (4) years’ experience in a healthcare setting or three (3) years’ experience with financial reporting or data analytics.

• Direct experience in medical billing, coding, or prior authorizations.
• Direct experience in enrolling patients in medication or copay assistance programs.
• Direct Experience in healthcare informatics.

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.

• Monitors daily medication charges to ensure correct documentation and charging and correct discrepancies found.
• Facilitates the addition, deletion, or correction of charges and coding to the charge master as needed.
• Assures utilization of all available indigent care programs for inpatient and outpatient administration of medications.
• Coordinates with Clinical Specialists to prioritize medication authorizations and patient assistance needed.
• Identifies patients requiring medication pre-certification or prior authorization at the time services are requested or when notified by clinical staff.
• Contacts insurance company or employer to determine eligibility and benefits for requested services.
• Proactively assists in researching departmental issues and involves proper information technology, contracting, or finance personnel to resolve issues as needed.
• Maintains database of major payer payment provisions and regulations.
• Optimizes Enterprise automated systems, researching and analyzing revenue and/or expense opportunities and implementing changes to realize improvements.
• Assists Pharmacy Analyst with monitoring purchases for contract compliance and accurate pricing.
• Assists Pharmacy Analyst with monthly budget reviews.
• Assists Pharmacy Analyst with pulling data needed to compile profile comparisons and generate reports related to current expenses to serve as the basis for the asking budget.
• Provides scheduled and ad hoc reports as needed to all levels of staff, management, and external agencies.
• Generates pharmacy spend advisor reports on a monthly basis to ensure that we are purchasing pharmaceuticals in the most cost efficient manner. Communicates those opportunities to Pharmacy Manager & Buyers. Follow up to assist with implementation of changes.
• Reviews expenditure activity by account by cost centers as expenditures are processed and according to accepted accounting practices and escalates to Pharmacy Analyst for further review if discrepancy found.
• Identifies irregular spending and system failures related to current expense activity and reports to department Director.
• Interacts with various hospital departments responsively and productively to promote efficient systems interface and…