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Pharmacist Reimbursement Specialist
2 months ago
The University of Miami Hospital and Clinics Sylvester Cancer Center is seeking a highly skilled Pharmacist Reimbursement Specialist to join our team. As a key member of our pharmacy department, you will be responsible for ensuring the accurate and efficient reimbursement of pharmacy services.
Key Responsibilities- Clinical Analysis and Reimbursement: Conduct thorough clinical and financial analyses to ensure accurate and timely reimbursement of pharmacy services.
- Formulary Management: Collaborate with the Utilization Review Department and providers to ensure clinically appropriate and cost-effective use of oncology and non-oncology therapy.
- Medication Maintenance and Billing: Perform continuous medication maintenance to ensure accurate third-party billing, including updates to HCPCS/CPT codes and validation of billing mechanisms to ensure compliance with federal and state regulations.
- Medication Use Evaluations: Conduct periodic reviews to assess the utilization and cost-effectiveness of oncology and non-oncology agents and optimize use accordingly.
- Revenue Integrity and Compliance: Participate in Pharmacy and Therapeutics Committee and ensure Revenue Integrity optimization through active Pharmacy participation and initiatives to support system growth.
- Medication Audits and Patient Assistance Programs: Complete regular systemic medication audits to identify trends and create mitigation strategies to improve processes leading to suboptimal reimbursement, and manage system-wide manufacturer-driven medication Patient Assistance Program (mPAP) for facility-administered oncology and non-oncology treatments for uninsured and underinsured patients.
- Education and Licensure: Requires current licensure in good standing in the State of Florida and a degree in Pharmacy from an accredited College of Pharmacy.
- Experience: Previous hospital experience preferred, with prior oncology experience beneficial but not required.
- Skills: Must possess good organizational, problem-solving, and computer skills, with strong written and verbal communication skills required for interacting with all levels of UMHC staff, physicians, and others.
The University of Miami offers a competitive salary and a comprehensive benefits package, including medical, dental, tuition remission, and more. As an academic medical center, we are proud to serve South Florida, Latin America, and the Caribbean, with a tradition of excellence in teaching, research, and patient care.
