Pharmacy Business Development Specialist
1 month ago
St. Luke's Health System is seeking a highly skilled Pharmacy Business Specialist to join our Pharmacy Administrative team. This is a new position created to support the pharmacy service line, which encompasses a wide range of programs and activities critical to our healthcare system.
Key Responsibilities- Support pharmacy contract and payer relations for retail and specialty pharmacies, ensuring requirements are appropriately met and updated accordingly.
- Assist in third-party payer negotiation activities.
- Manage defined processes to ensure effectiveness and efficiency in the pharmacy third-party payer contracting process and maintain databases (matrix rate updates and pricing accuracy) to ensure proper tracking, audits, reporting, analysis, and resolution.
- Implement and utilize state-of-the-art software and tools to streamline third-party contract administration/revenue optimization.
- Collaborate with finance, revenue cycle, managed care professionals to ensure optimal pharmacy contracting and revenue cycle capture.
- Monitor performance of the payer process to ensure optimal reimbursement.
- Provide solutions to contracting concerns.
- Evaluate and analyze data to develop and implement recommendations.
- Resolve issues collaboratively to ensure the best outcome for the patient and health system.
- Bachelor's degree or experience in lieu of degree.
- Preferred Qualifications:
- Pharmacy administrative experience.
- Contract management within pharmacy, insurance, or other business environment where the work performed required a basic knowledge of contracts, third-party insurance, and HIPAA.
- Knowledge of reimbursement practice and electronic claims processing.
- Experience with EPIC Willow Ambulatory.
At St. Luke's, caring for people in the communities we serve is our mission – and this includes our own SLHS team. We offer a robust benefits package to support our teams both professionally and personally. In addition to a competitive salary and retirement plans, we ensure our team feels supported in their benefits beyond the typical medical, dental, and vision offerings. We care about you and have fantastic financial and physical wellness options, such as:
- On-site massages.
- On-site counseling via our Employee Assistance Program.
- Access to the Virgin Pulse Wellness tool.
- Other formal training and career development offerings to ensure you are meeting your career goals.
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