Consultant | Healthcare Performance Improvement | Pharmacy and Clinic Services

2 months ago


Tampa, United States FORVIS Full time

Description & Requirements The Healthcare Consulting Performance Improvement team is looking for a Consultant to join the team in supporting clients in the Pharmacy and Clinic Services space specifically as it relates to compliance, program optimization, and financial performance. How you will contribute: Assist with Financial/Reimbursement assessments to determine reimbursement opportunities for on-campus and off-campus provider-based departments as well as freestanding and provider-based Rural Health clinics. Responsible for the financial analysis proactive calculations and modeling of new regulatory changes and impacts Assist with PowerPoint presentation reports Assist with developing provider-based strategy, gap assessments, and transition advisory processes. Provide guidance to clients regarding provider-based departments. Operational Assistance Split-billing (technical/professional) Chargemaster requirements CMS Provider-Based Clinic regulations and Federal and State regulations Compliance with provider-based rule requirements CMS Checklists Assimilate provider-based checklists (attestations) Assist with transitions to Rural Health Clinic (RHC) or Provider Based RHC Policy and Procedure Development Survey readiness assistance Become proficient in provider-based (42 CFR 413.65) and RHC regulations and stay abreast of ongoing legislative changes. Prepare Medicare RHC cost reporting schedules. Calculating RHC visits Calculating FTEs for productivity Provide guidance to clients regarding their 340B and other pharmacy operations: Policy and Procedure Development 340B network expansion i.e., development of contract pharmacy arrangements, child sites, direct purchases, orphan drugs, and other opportunities Operational Assistance Split-billing vendor implementations Split-billing vendor maintenance i.e., Drug Crosswalk Maintenance Compliance Reviews Independent Reviews HRSA Audit Experience a plus Advise, communicate, and present to all levels including C-suite, management, and clinic staff. Provide in-depth provider-based processes and regulatory knowledge to clients. Provide an unmatched client experience and identify additional value-added services Active participant in specific healthcare industry groups (Becker's, Apexus, 340B Health, HFMA, etc.) We are looking for people with Forward Vision and: Strong analytical and communication skills Ability to deliver work products consistently and with high-quality. Demonstrated ability to think independently and train other team members as needed. Ability to travel up to 50%, depending on client commitments. Highly motivated and self-driven to exceed client needs and timelines. Minimum Qualifications: Bachelor's degree in Business, Accounting, Finance, Health Services Administration, or a related field 2 years or more of experience working within the healthcare industry, specifically consulting or with a hospital Significant experience in advanced Excel, IT platforms, and healthcare Strong technical skills, experience with spreadsheets, databases, and an automated audit work paper system Experience with project management Preferred Qualifications: Experience in the following areas: Healthcare provider-based billing Provider-based attestation compliance and submission to Medicare Medicare/Medicaid Hospital cost reporting Practice operational knowledge in provider-based physician practices, or RHCs. EPIC Data visualization (Tableau or Power BI) #LI-TPA, #LI-ATL, #LI-OAK, #LI-IND, #LI-KCMO, #LI-STL, #LI-CLTSP, #LI-CIN, #LI-NASH, #LI-DFW #LI_BM1



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    Description & Requirements The Healthcare Consulting Performance Improvement team is looking for a Consultant to join the team in supporting clients in the Pharmacy and Clinic Services space specifically as it relates to compliance, program optimization, and financial performance. How you will contribute: Assist with Financial/Reimbursement assessments...


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