Pharmacy Revenue Cycle Manager

4 weeks ago

Palo Alto, California, United States Stanford Health Care Full time
Job Title: Pharmacy Revenue Cycle Manager

Job Summary:

The Pharmacy Revenue Cycle Manager will lead the development and execution of Pharmaceutical Revenue Cycle program initiatives, working closely with stakeholders across the organization to drive operational and strategic change. This role is responsible for leading a portfolio of projects designed to optimize the financial health of Stanford Health Care.

Key Responsibilities:

  • Provides leadership in all components of Pharmaceutical Revenue Cycle Services within the Pharmacy department.
  • Leads and strategizes new pharmaceutical product launches and optimizes outcomes with numerous external stakeholders.
  • Provides Pharmaceutical Revenue Cycle guidance and leadership in identifying program initiatives in alignment with SHC Revenue Cycle strategic objectives.
  • Actively participates in strategic committee discussions and activities, taking a leadership role in organizing projects or initiatives to support committee goals.
  • Serves as a Revenue Cycle methodology expert on pharmaceutical charges, pricing, and costing.
  • Provides performance improvement methodology guidance on Pharmaceutical Revenue Cycle operations to pharmacy and external leaders.
  • Contributes to positive business results by maintaining a workplace characterized by high performance, mutual support, and respect, and teamwork.
  • Regularly searches for and identifies opportunities for quality and process improvement, resulting in improved efficiency and increased productivity.
  • Collaborates with the Pharmacy Finance team to align with revenue projections and budget compilation.
  • Provides support for Strategic Pricing Executive Council, Strategic Pricing-Finance, and Managed Care for payor negotiations, audit, and pricing compliance.
  • Develops appropriate KPIs and drafts suitable dashboard managers for each work stream and fully scopes the pharmacy revenue cycle process to identify opportunities, define resource needs, understanding both inpatient and outpatient pharmacy operations, as well as pharmaceutical procurement, clinical approval processes, charge generation, and 340B costing.
  • Serves as Pharmacy Department expert on matters related to commercial and government payment terms for pharmacy-related services.

Requirements:

  • Bachelor's degree in health care, Finance, Business Administration, or a related field.
  • Advanced degree such as Masters, MBA, JD, PharmD is desired.
  • 5-7 years of progressively responsible and directly related work experience in pharmacy-related areas, with an understanding of overall pharmaceutical revenue cycle management, billing, insurance claim follow-up, and denial management processes.
  • A minimum of 5 years of managerial and/or supervisory experience is required.
  • Advanced knowledge of pharmaceutical revenue cycle operations preferred.

Preferred Qualifications:

  • A strategic understanding and broad view of hospital revenue cycle operations.
  • Understanding of pharmacy business and finance operations.
  • Business and financial management, including the ability to analyze data for operations, budgeting, auditing, and forecasting.
  • Excellent interpersonal skills, with a demonstrated ability to work with a wide variety of people, both within the organization and externally.
  • Demonstrated ability to interact effectively with peers and subordinates.
  • Demonstrated quantitative analytical skills.
  • Demonstrated organization and planning skills.
  • Demonstrated knowledge and understanding of Lean, project management, and/or Six Sigma principles and their applications.
  • Demonstrated ability to work independently and complete assignments effectively.
  • Excellent computer skills in a Microsoft Windows environment, including intermediate proficiency in Excel.
  • Excellent organizational skills.
  • Ability to plan, organize, and effectively lead multi-disciplinary teams and projects, delivering meaningful results within established time frames.
  • Ability to act as a thought leader for performance improvement and pharmaceutical revenue cycle methodologies.
  • Ability to communicate effectively at all organizational levels, both orally and in writing.
  • Ability to establish and maintain effective relationships with widely diverse groups, including individuals at all levels both within and outside the organization.
  • Ability to motivate, influence, and direct the work of others.
  • Ability to resolve conflicts and/or negotiate with others to achieve positive results.
  • Ability to work well both autonomously and as a team player.
  • Flexible and adaptable to change while working in a fast-paced environment.

Stanford Health Care Commitment:

Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of our patients, families, and towards each other.

C-I-CARE is the foundation of Stanford's patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing, and recovery.

You will do this by executing against our three experience pillars, from the patient and family's perspective:

  • Know Me: Anticipate my needs and status to deliver effective care.
  • Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health.
  • Coordinate for Me: Own the complexity of my care through coordination.

Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment.

Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above.

People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply.

Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.

Base Pay Scale: Generally starting at $108.02 per hour

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty, and training.

This pay scale is not a promise of a particular wage.

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