You bring your body, mind, heart and spirit to your work as the Pharmacy Revenue Manager.
Youâ™re generous with your thoughts, your partnerships and especially your voice, because your opinion matters.
Youâ™re great at what you do, but you want to be part of something even greater. Because you believe that while individuals can be strong, the right team is invincible.
System Services is our Corporate Headquarters in Broomfield, Colorado and is located within the Oracle campus. SCL Health is a faith-based, nonprofit healthcare organization dedicated to improving the well-being of the people we serve.
Benefits are one of the ways we encourage health for you and your family. Our generous package includes medical, dental and vision coverage. But health is more than a well-working body: it encompasses body, mind and social well-being. To that end, weâ™ve launched a Healthy Living program to address your holistic health. Healthy Living includes financial incentives, digital tools, tobacco cessation, classes, counseling and paid time off. We also offer financial wellness tools and retirement planning.
Together weâ™ll align mission and careers, values and workplace. Weâ™ll encourage joy and take pride in our integrity.
Weâ™ll laugh at each otherâ™s jokes (even the bad ones). Weâ™ll hello and high five. Weâ™ll celebrate milestones and acknowledge the value of spirituality in healing.
Weâ™re proud of what we know, which includes how much there is to learn.
As the Pharmacy Revenue Manager you need to know how to:
Collaborate with Finance, Revenue Integrity, STSC, RSC, Compliance, Decision Support, Pharmacy, and other departments to standardize and optimize pharmacy charging workflows, pharmacy revenue, business processes, billing, denial management, and collections.
Collaborate with sites, managed care, and the business office to decrease medicationârelated claim denials and outstanding claims. Collaborates with other departments that have indirect impact on pharmaceutical charging and billing (e.g. Coding, HIM, Patient Access).
Collaborate with Director of Pharmacy Business Services, provides assistance on 340B operational reporting as it pertains to hospital outpatient departments, Dir. Specialty Pharmacy to determine patient access to high cost injectable therapies and other related reimbursement options. Collaborates with Pharmacy & Therapeutics Committees, Oncology Service Lines, and Managed Care to align formularies.
Lead pharmacy charging or revenue related projects and workflow changes, document areas of risk, financial impact and workflow procedures.
Provide recommendations to reporting teams for optimal pharmacy workload statistics and other pharmacy reports or dashboards. Develops analytical tools to audit and analyze hospital pharmacy data elements to ensure accurate billing and maximal revenue capture. Communicates findings to management and overseeing the implementation of approved recommendations to ensure appropriate revenue capture.
Research and stay current with important billing and revenue related compliance and optimization topics to guide appropriate organizational decisions. Develops policies, guidelines, and procedures for pharmaceutical coding, billing, pricing, charging, and denial management to maximize reimbursement and compliant charging.
Manage quality reviews in order to ensure that Pharmacy Charge Description Master (PCDM) additions, inactivations, changes and/or revisions were accurately completed in the hospitals clinical and financial system. Provides oversight to (PCDM) including assignment of HCPCS/CPT codes, charge tables, linked procedures, etc. Participates in the financial analyses of any proposed changes to determine charge and revenue implications related to the (PCDM) maintenance. Develops quality metrics and audit methodologies to drive accuracy and first time quality for all HCPCS/CPT codes, revenue codes, billable units, multipliers, modifiers, indications, etc.
Qualified candidate may work 100% remote
We hire people, not resumes. But we also expect excellence, which is why we require:
Bachelorâ™s in Pharmacy / PharmD, required
MBA, MISM level degree or other Informatics training, preferred
Pharmacist / Current licensure in the State of Colorado, required
Minimum of six (6) years of hospitalâbased pharmacy operation and two (2) years of hospitalâbased revenue cycle experience, required
Minimum of two (2) years in a professional leadership role (project manager, lead, supervisor or above) in a hospital setting, required
Minimum of one (1) year using an Epic (Willow) hospital clinical and billing software system, required
Direct experience managing projects across a multiâdisciplinary team, required
Vitalware, MS Office products (Excel and Word), and Google Gmail proficiency, preferred
Your next move.
Now that you know more about this role and our team we hope youâ™ll join us. At SCL Health youâ™ll reaffirm every day how much you love this work, and why you were called to it in the first place.
Internal Number: 20006640
About SCL Health
SCL Health is a faith-based, nonprofit healthcare organization dedicated to improving the health of the people and communities we serve, especially those who are poor and vulnerable. Founded by the Sisters of Charity of Leavenworth in 1864, our $2.8 billion health network provides comprehensive, coordinated care through eight hospitals, more than 150 physician clinics, and home health, hospice, mental health and safety-net services primarily in Colorado and Montana.