Company:
Emory Healthcare
Location: Atlanta
Closing Date: 04/11/2024
Hours: Full Time
Type: Permanent
Job Requirements / Description
Overview:
Where you matter as much as the work you do
Join Emory Healthcare (EHC) if you’re looking for an opportunity with one of the nation's leading Atlanta hospitals in cardiology and heart surgery, cancer, neurology, and more! EHC is where those around you are dedicated to the power of teamwork, fostering an environment where you can learn, grow, and innovate with similarly passionate professionals. Work with us to improve the quality of life throughout Georgia through partnerships with the U.S. Centers for Disease Control and Prevention, Georgia Institute of Technology, and other organizations and make a bigger, greater impact than you ever thought possible.
Description:
8:30a – 5:00p / Full Time / 40 Hours
The Revenue Cycle Pharmacist Specialist practices as an expert in pharmacy revenue integrity and optimization. This position is responsible for ensuring accurate medication charge capture, billing, and reimbursement across the institution. In addition to maintaining regulatory compliance and supporting appropriate medication therapy, the Revenue Cycle Pharmacist Specialist is pivotal in managing medication utilization, financial stewardship, and pharmacy-related revenue cycle activities.
Key Responsibilities:
Revenue Cycle Expertise: Serves as the primary pharmacist for ensuring medication charge capture accuracy, including review of charge reconciliation, billing workflows, and revenue integrity strategies. Leads the development and reinforcement of policies and processes to ensure financial medication stewardship, such as optimizing charge descriptions and maintaining accuracy in coding and billing practices. Analyzes and interprets billing data, including charge capture rates, reimbursement variances, and medication denial trends. Develops dashboards and financial reports to track key performance indicators for pharmacy revenue. Participates in formulary review processes, focusing on financial impact, medication access, and alignment with insurance coverage and reimbursement guidelines.
340B Support: Helps provide additional support with 340B Drug Pricing Program requirements, including split-billing software oversight, contract pharmacy optimization, and compliance monitoring. Analyzes medication utilization trends to identify opportunities for cost savings, revenue enhancement, and optimization of reimbursement. Develops and implements system-wide medication use guidelines that support cost-effective prescribing and minimize financial risk. Coordinates and leads internal and external audits related to pharmacy revenue, reimbursement, and 340B compliance.
Collaborative Practice: Acts as a liaison between the pharmacy, finance, and revenue cycle teams to optimize reimbursement and resolve complex billing issues. Leads the implementation of system-wide financial policies related to high-cost medications and specialty pharmaceuticals. Coordinates with managed care and payer contracting teams to support medication access and affordability. Reviews and addresses audit findings, working to mitigate financial risk.
Education and Training: Provides training and support to pharmacy staff, providers, and revenue cycle personnel on best practices for medication charge capture, billing, and reimbursement. Develops and promotes education initiatives on 340B, reimbursement, and regulatory compliance. Actively participates in multidisciplinary system committees focused on medication reimbursement, compliance, and financial stewardship. Leads the development of pharmacy-related revenue cycle projects.
MINIMUM QUALIFICATIONS:
Graduate of an accredited school of pharmacy.
ASHP-Accredited Post Graduate Year 1 (PGY1) and/or PGY2 Residency or Fellowship in Pharmacy Administration, Health-System Pharmacy, or a relevant specialty, OR equivalent experience in revenue cycle management, pharmacy finance, or medication reimbursement.
Relevant Pharmacy Specialty Board certification (e.g., BCPS, BCACP) is preferred.
Active Georgia Pharmacist license or eligibility for licensure within 60 days of hire.
Experience with 340B program management, pharmacy revenue cycle workflows, and payer reimbursement is strongly preferred.
JOIN OUR TEAM TODAY! Emory Healthcare (EHC), part of Emory University (EUV), is the most comprehensive academic health system in Georgia and the first and only in Georgia with a Magnet® designated ambulatory practice. We are made up of 11 hospitals-4 Magnet® designated, the Emory Clinic, and more than 425 provider locations. The Emory Healthcare Network, established in 2011, is the largest clinically integrated network in Georgia, with more than 3,450 physicians concentrating in 70 different subspecialties.
Additional Details:
Supporting a diverse, equitable and inclusive culture. Emory Healthcare (EHC) is dedicated to providing equal opportunities and access to all individuals regardless of race, color, religion, ethnic or national origin, gender, genetic information, age, disability, sexual orientation, gender identity, gender expression and/or veteran's status. EHC does not discriminate on the basis of any factor stated above or prohibited under applicable law. EHC respects, values, and celebrates the unique perspectives and backgrounds of all individuals. EHC aspires to create an environment of collaboration and true belonging for all our patients and team members. Emory Healthcare (EHC) is committed to achieving a diverse workforce through equal opportunity and nondiscrimination policy in all aspects of employment including recruitment, hiring, promotions, transfers, discipline, terminations, wage and salary administration, benefits, and training.
ACCOMODATIONS: EHC will provide reasonable accommodations to qualified individuals with disabilities upon request. To request this document in an alternate format or to request a reasonable accommodation, please contact the Office of Diversity, Equity, and Inclusion.”
PHYSICAL REQUIREMENTS (Medium): 20-50 lbs; 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 50 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.
ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock , Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation , Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.
Where you matter as much as the work you do
Join Emory Healthcare (EHC) if you’re looking for an opportunity with one of the nation's leading Atlanta hospitals in cardiology and heart surgery, cancer, neurology, and more! EHC is where those around you are dedicated to the power of teamwork, fostering an environment where you can learn, grow, and innovate with similarly passionate professionals. Work with us to improve the quality of life throughout Georgia through partnerships with the U.S. Centers for Disease Control and Prevention, Georgia Institute of Technology, and other organizations and make a bigger, greater impact than you ever thought possible.
Description:
8:30a – 5:00p / Full Time / 40 Hours
The Revenue Cycle Pharmacist Specialist practices as an expert in pharmacy revenue integrity and optimization. This position is responsible for ensuring accurate medication charge capture, billing, and reimbursement across the institution. In addition to maintaining regulatory compliance and supporting appropriate medication therapy, the Revenue Cycle Pharmacist Specialist is pivotal in managing medication utilization, financial stewardship, and pharmacy-related revenue cycle activities.
Key Responsibilities:
Revenue Cycle Expertise: Serves as the primary pharmacist for ensuring medication charge capture accuracy, including review of charge reconciliation, billing workflows, and revenue integrity strategies. Leads the development and reinforcement of policies and processes to ensure financial medication stewardship, such as optimizing charge descriptions and maintaining accuracy in coding and billing practices. Analyzes and interprets billing data, including charge capture rates, reimbursement variances, and medication denial trends. Develops dashboards and financial reports to track key performance indicators for pharmacy revenue. Participates in formulary review processes, focusing on financial impact, medication access, and alignment with insurance coverage and reimbursement guidelines.
340B Support: Helps provide additional support with 340B Drug Pricing Program requirements, including split-billing software oversight, contract pharmacy optimization, and compliance monitoring. Analyzes medication utilization trends to identify opportunities for cost savings, revenue enhancement, and optimization of reimbursement. Develops and implements system-wide medication use guidelines that support cost-effective prescribing and minimize financial risk. Coordinates and leads internal and external audits related to pharmacy revenue, reimbursement, and 340B compliance.
Collaborative Practice: Acts as a liaison between the pharmacy, finance, and revenue cycle teams to optimize reimbursement and resolve complex billing issues. Leads the implementation of system-wide financial policies related to high-cost medications and specialty pharmaceuticals. Coordinates with managed care and payer contracting teams to support medication access and affordability. Reviews and addresses audit findings, working to mitigate financial risk.
Education and Training: Provides training and support to pharmacy staff, providers, and revenue cycle personnel on best practices for medication charge capture, billing, and reimbursement. Develops and promotes education initiatives on 340B, reimbursement, and regulatory compliance. Actively participates in multidisciplinary system committees focused on medication reimbursement, compliance, and financial stewardship. Leads the development of pharmacy-related revenue cycle projects.
MINIMUM QUALIFICATIONS:
Graduate of an accredited school of pharmacy.
ASHP-Accredited Post Graduate Year 1 (PGY1) and/or PGY2 Residency or Fellowship in Pharmacy Administration, Health-System Pharmacy, or a relevant specialty, OR equivalent experience in revenue cycle management, pharmacy finance, or medication reimbursement.
Relevant Pharmacy Specialty Board certification (e.g., BCPS, BCACP) is preferred.
Active Georgia Pharmacist license or eligibility for licensure within 60 days of hire.
Experience with 340B program management, pharmacy revenue cycle workflows, and payer reimbursement is strongly preferred.
JOIN OUR TEAM TODAY! Emory Healthcare (EHC), part of Emory University (EUV), is the most comprehensive academic health system in Georgia and the first and only in Georgia with a Magnet® designated ambulatory practice. We are made up of 11 hospitals-4 Magnet® designated, the Emory Clinic, and more than 425 provider locations. The Emory Healthcare Network, established in 2011, is the largest clinically integrated network in Georgia, with more than 3,450 physicians concentrating in 70 different subspecialties.
Additional Details:
Supporting a diverse, equitable and inclusive culture. Emory Healthcare (EHC) is dedicated to providing equal opportunities and access to all individuals regardless of race, color, religion, ethnic or national origin, gender, genetic information, age, disability, sexual orientation, gender identity, gender expression and/or veteran's status. EHC does not discriminate on the basis of any factor stated above or prohibited under applicable law. EHC respects, values, and celebrates the unique perspectives and backgrounds of all individuals. EHC aspires to create an environment of collaboration and true belonging for all our patients and team members. Emory Healthcare (EHC) is committed to achieving a diverse workforce through equal opportunity and nondiscrimination policy in all aspects of employment including recruitment, hiring, promotions, transfers, discipline, terminations, wage and salary administration, benefits, and training.
ACCOMODATIONS: EHC will provide reasonable accommodations to qualified individuals with disabilities upon request. To request this document in an alternate format or to request a reasonable accommodation, please contact the Office of Diversity, Equity, and Inclusion.”
PHYSICAL REQUIREMENTS (Medium): 20-50 lbs; 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 50 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.
ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock , Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation , Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.
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Emory Healthcare