Oversees Pharmacy charge master files, develops and implements processes to improve charge capture for pharmacy billing and compliance with regulatory requirements in an effort to enhance quality of care and contain costs. Develop and standardize monitoring of controlled substances to minimize diversion and provide oversight in inpatient, outpatient and retail settings. Monitor outpatient pharmacist clinic charges. Support the system-wide compliance program by developing and implementing content for compliance education and training. Serve as an in-house expert on Pharmacy billing practices. Responsible for coordination with Rates & Reimbursement and clinical informatics, integration of all pharmacy information systems and pharmacy initiatives related to Pharmacy billing.
EDUCATION: Bachelor's degree in Business or Informatics, or an equivalent combination of education and years of related experience.
EXPERIENCE: 5 years of experience with state and federal laws and regulations related to pharmacy operations, revenue cycle and state pharmacy regulations.
LICENSE/CERT/REG: Maryland Pharmacy Technician registration required. Pharmacy Technician certification through a nationally accredited certification examination (such as the Pharmacy Technician Certification Board, or equivalent) required.
SKILLS: Excellent interpersonal, analytical, writing, and presentation skills a must. Must also possess basic managerial finance skills and have the ability to perform financial (cost/benefit) analyses. Basic understanding of hospital and home care pharmacy operations, and the ability to apply this knowledge in analyzing operations is essential. Strong planning, problem solving and change management skills. Demonstrated leadership skills and abilities, including the ability to lead diverse work teams.