Pharmacy Revenue Analytics Program Lead
Children's National HospitalAbout the role
Description
The Pharmacy Revenue Analytics Program Lead, reporting to the Clinical Ancillary Services Business Director and Vice President & Chief Pharmacy Officer, will define and carry out the data and process improvement strategy for maximizing Pharmacy revenue. S/he, in concert with Pharmacy Informatics, will ensure the availability and interpretation of reporting and analytics necessary for the Division to drive financial improvements. The position entails financial modeling, financial impact analysis, revenue forecasting, drug utilization analysis, markup analysis, and ad hoc reporting. The Program Lead will work directly with Pharmacy staff and leadership to ensure the quality and efficiency of all elements of charge capture. The Program Lead will oversee revenue improvement initiatives, and actively develop, interpret, review, and share data from all phases of the pharmacy revenue cycle process to identify opportunities for charge capture improvement and gross revenue optimization. Independently works with the appropriate departments and revenue leaders to resolve Pharmacy revenue management issues, analyze key data metrics, systematically review data findings, and make recommendations to improve revenue capture and reconciliation. The program Lead serves as the key leader and subject matter expert within the organization who monitors and improves Pharmacy data and revenue processes for the Division.
Qualifications
Minimum EducationBachelor's Degree Or Equivalent Experience (Required) Or
Master's Degree Or Equivalent Experience (Preferred)
Minimum Work Experience
6 years Healthcare experience in pharmacy charge capture, revenue cycle, finance, decision support, or other related business analytics (Required)
3 years Experience with revenue cycle/financial information systems (Required)
2 years Previous supervisory experience (Preferred)
Required Skills/Knowledge
Demonstrated ability to conduct broad and detailed financial data analysis, identify and prioritize opportunities, and manage teams and processes to drive change.
Superior technical skills including proficiency in the Microsoft Suite of applications (Excel, Word, PowerPoint, Access).
Ability to work in a team environment with other analysts, managers, and clinicians.
Demonstrated ability to work independently, prioritize workload, be flexible, make decisions, and participate in continuing education and professional organizations as part of professional development opportunities.
Proficiency in the effective presentation of analytical results to various audience levels.
Solid understandin of Information Systems principles in order to effectively analyze and make decision; familiarity with the Cerner system is ideal.
Ability to think strategically in connecting data flows into big picture business outcomes.
Demonstrated ability to facilitate team or group activities and demonstrated leadership qualities including professional verbal and written communication skills.
Knowledge and understanding of the configuration relationships between the subsystems, applications, modules, etc. Maintains in-depth knowledge of platform data models.
Required Licenses and Certifications
Not Applicable . Not Applicable .
Functional Accountabilities
Revenue Optimization Program Administration
- Develop policies, guidelines, and procedures for pharmaceutical coding, billing, pricing, charging, and denial management to maximize reimbursement and compliant charging.
- Perform quality reviews i
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