Pharmacy Manager - Revenue Cycle

Company: CEDARS-SINAI
Location: Inglewood
Posted on: August 7, 2022

Job Description:

Make a Difference in PharmacyWhen the work you do every single day has a crucial impact on the lives of others, every effort, every detail, and every second matters. This shared culture of passion and dedication pulses through Cedars-Sinai, and it's just one of the many reasons we've achieved our fifth-consecutive Magnet designation for nursing excellence. From working with a team of premier healthcare professionals to using state-of-the-art facilities, you'll have everything you need to do something incredible-for yourself, and for others. Join us, and discover why U.S. News & World Report has named us one of America's Best Hospitals!Cedars-Sinai Medical Center is an 886-bed non-profit, acute, quaternary, teaching Level I Trauma Center hospital located in the heart of Los Angeles, California. The Department of Pharmacy has over approximately 430 staff members who provide comprehensive inpatient pharmacy services as well as outpatient services via 2 cancer centers and 3 outpatient pharmacies. We are committed to the education and training of pharmacists, students/interns, residents, technicians, and other health care professionals. We are affiliated with several Schools of Pharmacy and offers PGY1 and PGY2 residency programs. The residency and student experiential programs at CSMC continue to grow with every successive year, where nearly 100 residents have graduated from the PGY1 pharmacy residency program since 1985 and more than 200 student rotations are offered at CSMC annually. Recently, CSMC was recognized and bestowed "Site of the Year" awards by two major affiliated CA Schools of Pharmacy for providing an exceptional experiential learning environment for their students.What's this role all about?The Pharmacy Revenue Cycle Manager at Cedars-Sinai Medical Center will focus on Revenue Cycle/Integrity/New Business Development. Overseeing and ensuring 100% revenue capture as well as identifying new revenue stream across the enterprise through robust strategies in the areas of revenue cycle, accurate coding and chargemaster maintenance, denial management, and prior authorization. The manager also monitors the profit/loss for the various pharmacy locations across the enterprise on a routine basis. Denial management.

• Pharmacy revenue cycle/integrity
• New business development and new revenue stream.
• Work with Tableau data to evaluate profit margin and denials for high cost and oncology drugs across the enterprise (acute care, MD dispensing sites and affiliates)
• Collaborate with clinical prior authorization team
• Collaborate with Patient assistance and free drug programs
• Accurate coding for the Charge Master
• Accurate and timely billing of medication charges
• NTAP program
• Oversee auditing process for areas of responsibilities
• Stay up to date with CMS, Medi-Cal, and commercial payers on payment policy
• Monitor the profit/loss of various pharmacy programs and locations across the enterprise
• Annual cost/charge update to meet revenue target
• Quarterly 340B cost update to the Charge Master
• Hiring and supervision of approximately 4 pharmacists and 6 technicians FTEs
• Participation in medical center interdisciplinary committees and initiatives
• Precepting pharmacy residents and students#Jobs-Indeed
  Educational Requirements:
  • PharmD degree requiredLicenses:
    • Current California pharmacist licensure
    • BLS cardWhat else are we looking for?
      • Completion of a PGY-2 Residency in Drug Use Policy or equivalent practice experience.Physical Demands:
        • Frequent standing; walking, bending; reaching, occasional sitting, pushing & pulling, lifting of materials up to 40 pounds for distances to 10 feet.
        • Responsiveness to auditory alarms and communication devices including: telephones, beepers, fire alarms, and mechanical failure alarms.
        • Sufficient mobility to access equipment, patients and other customers.
        • Able to read information on medication labelsWork Environment (work environments, hazards and exposures that may be encountered on the job):
          • Exposure to minimal but constant noise levels.
          • Repetitive hand motions.
          • Some functions may include incidental exposure to hazards associated with preparation of hazardous medications.
          • Some functions may require use of personal protective equipment.
          • Use of standard precautions for infection control.
            Working Title:Pharmacy Manager - Revenue Cycle
            Department:Pharmacy-Stores-Mfg
            Business Entity:Clinical & Support Services
            Job Category:,Pharmacy,Pharmacy
            Job Specialty:Pharmacy
            Position Type:Full-time
            Shift Length:8 hour shift
            Shift Type:Day

Keywords: CEDARS-SINAI, Inglewood , Pharmacy Manager - Revenue Cycle, Executive , Inglewood, California