Position Summary: We have an exciting opportunity to join our team as a Mgr-Pharm Business & Analytics.
In this role, the successful candidate This position monitors and manages Pharmacy Revenue Cycle Management (RCM) split-billing software reports to ensure regulatory compliance and optimization of 340B Program revenue. Responsibility for diversion monitoring, drug-cost monitoring to ensure 340B and GPO pricing integrity. Manages formulary matrix performance reporting and responds to alerts for mapping, Penny Buys and revenue-integrity analytics. Performs mapping, Conversion Factor Maintenance, File extractions & connectivity (ongoing support), IT/Epic/Willow support, reporting and monitoring, compliance (GPO Prohibition), reimbursement and cost report collaboration, current and future opportunities, inventory maintenance and monitoring (child site outpatient pharmacy inventory monitoring and reporting). Additionally, assists with writing of policies and procedures, education and training and HRSA registration site ongoing maintenance. The position also requires working with multiple departments and pharmacy sites to improve cost containment, improve efficiency and develop new and innovative solutions to continuously improve pharmacy service, while maximizing pharmacy charge capture, taking care to be compliant with all federal and state regulations.
Ensure compliance with all regulatory standards for 340B program and help maintain and support 340B compliance, operations and optimization, including, but not limited to auditing and monitoring (and reporting), medication procurement, interdepartmental communication and direct and indirect pharmacy operations.
Constantly monitor retail and specialty prescriptions for HOPs and contract pharmacies and ensure regulatory compliance and continuous growth.
Works directly with all NYU sites to optimize 340B opportunities.
Maintain Pharmacy acquisition, WAC, GPO and 340B costs and assists in charge configuration reviews with revenue cycle and willow teams. This will require routine consult with the pharmacy purchasing staff and the pharmacy drug wholesaler to ensure accurate pricing and purchase unit configuration in all related electronic billing systems.
Work closely with Revenue Cycle Management and Medication Pricing Committee, while utilizing RCM Drug Cost reports and resources to identify and investigate discrepancies between 340B, WAC and GPO pricing. Investigates and resolves discrepancies with the drug wholesaler and further pursues resolution with other resources as necessary, monitor potential supply chain issues with wastage, shrinkage, revenue integrity analytics, billing and multiplier issues and mismatches between clinical and financial charge databases, while taking care to identify and optimize revenue opportunities, as well.
Assessing data for new pharmacy opportunities and clinical services, while utilizing critical thinking skills to constantly be innovative and creative with potential solutions.
Liaison to 340B software, vendor, consultant and Pharmacy. Attend meetings as required.
Performs billing QA before and after price upload as well as when new medications are approved by P&T.
Assists and supports Pharmacy Drug File maintenance.
Supports related pharmacy applications (EMR, automation technology, etc.), including, but not limited to, system upgrade and maintenance, which may require working during off hours. Prepares system generated report to support Pharmacy operations and is available for system troubleshooting and downtimes.
Work closely with strategic sourcing and medication use advancement by providing analyses to evaluate pharmacy opportunities, medication conversions and system wide contracting to reduce medication cost.
Assists and supports employee training for systems utilization and adaptation.
Supports a non-punitive reporting approach when medication variances are identified as due to an individual/group involvement. Provides tools and coaching sessions, when necessary, to establish an environment for improvement.
Serves as a member of the pharmacy departments leadership team.
Supports an environment dedicated to the safety of our patients and staff and facilitate a perpetual efficiency-improvement process in the medication-use physical environment.
Precepts pharmacy students and residents if so assigned.
Collaborates with Risk Management and QA Departments as necessary.
Supports other Pharmacy functions as needed.
Participates in scholarly/professional activities.
Supervises, directs, guides and coordinate activities of appropriate Pharmacy Staff, as appropriate.
Minimum Qualifications: To qualify you must have a PharmD or Bachelor's degree with a minimum of 2 years related work experience or an equivalent combination of education and experience..
Required Licenses: Pharmacist License-NYS
Preferred Qualifications: Pharmacist in the state of NY. Graduate degree in MBA (Master of Business Administration), MHA (Master of Health Administration), Post graduate (PGYI or PGYII) training or related field. Knowledge in Six Sigma.
Qualified candidates must be able to effectively communicate with all levels of the organization.
NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.
NYU Langone Health is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online. If you wish to view NYU Langone Health's EEO policies, please click here. Please click here to view the Federal 'EEO is the law' poster or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information. To view the Pay Transparency Notice, please click here.