Pharmacist / Revenue Integrity

2 weeks ago

Atlanta, United States Emory Healthcare Full time
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-5p / Full Time / 40 Hours

The Revenue Integrity Pharmacist serves as a key expert in the optimization of medication-related revenue cycle processes within the healthcare institution. This position ensures accurate medication billing, coding, and reimbursement, aligning clinical practice with financial goals while maintaining compliance with regulatory standards. The pharmacist practices as a clinical and financial expert in medication revenue integrity, contributing to the financial health of the institution while ensuring appropriate patient care.

Key Responsibilities:

  • Revenue Cycle Management: Collaborates with finance, coding, and clinical teams to ensure accurate and compliant medication billing and coding. Reviews and audits medication charges to identify discrepancies and areas for improvement.
  • Clinical and Financial Integration: Works to ensure that medication therapy decisions are aligned with revenue cycle processes, optimizing reimbursement while maintaining high standards of patient care.
  • Compliance: Ensures institution-wide compliance with federal, state, and payer-specific regulations regarding medication billing and coding. Develops and promotes policies and procedures that support compliance in revenue-related activities.
  • Medication Charge Capture: Proactively reviews and processes medication orders to ensure accurate charge capture. Monitors and resolves issues related to charge capture, including denials and underpayments, to support financial integrity.
  • 340B Program Partnership and Oversight: Maintains and promotes understanding of 340B practices as applicable, ensuring compliant and optimized savings through the program.
  • Interdisciplinary Collaboration: Works closely with pharmacy, finance, IT, and other departments to develop and implement strategies that enhance revenue cycle performance related to medication use.
  • Education and Training: As needed, develops and conducts training programs for pharmacy staff and other healthcare providers on revenue cycle best practices, billing, coding, and compliance.

Additionally, as needed, precepts pharmacy students and residents, focusing on the intersection of clinical care and revenue integrity. Data Analysis and Reporting: Analyzes data related to medication use, billing, and reimbursement. Provides regular reports to leadership on revenue cycle performance, identifying trends and areas for improvement. Quality Improvement: Leads or participates in medication use evaluations, quality improvement projects, and initiatives to enhance revenue integrity and patient safety. Financial Stewardship: Actively participates in formulary review and medication selection to promote cost savings and financial sustainability. Supports and promotes cost-saving initiatives while maintaining quality patient care. Regulatory Oversight: Participates in multidisciplinary committees and ensures adherence to regulatory and accreditation standards in revenue cycle practices. MINIMUM QUALIFICATIONS:

  • Graduate of an accredited school of pharmacy.
  • ASHP-Accredited Post Graduate Year 1 and/or Year 2 Residency or Fellowship or equivalent experience in revenue cycle or pharmacy administration.
  • Certification in revenue cycle or revenue integrity is preferred.
  • Active Georgia Pharmacist license or eligibility for licensure within 60 days of hire.
  • Basic Life Support (BLS) Certification required.

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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