SUMMARY: Supports, coordinates, collects and reports on a variety of Pharmacy administrative activities; performs operational and administrative support duties and other related duties as required for pharmacy leadership.
DUTIES & ESSENTIAL JOB FUNCTIONS: NOTE: The following are the duties performed by employees in
this classification. However, employees may perform other related duties at an equivalent level. Not all duties
listed are necessarily performed by each individual in the classification.
1. Identifies areas of concern and helps develop corrective plans of action related to billing and financial reconciliation for Highland Pharmacy.
2. Coordinates and implements various Pharmacy Services related projects; provides operational and procedural support to pharmacy leadership.
3. Coordinates monthly prescription claim reconciliation and review of the explanation of benefits (EOB).
4. Maintains reports for financial reconciliation for the pharmacy department for inpatient and outpatient billing.
5. Serves as the point person for the investigation and resolution of charging and payment discrepancies.
6. Actively monitors the charges for outpatient prescriptions, and ensures that proper billing and reimbursement is occurring.
7. Serves as the point person for issues related to Medi-Cal such as the coordination of share of cost tracking and documentation by outpatient technicians, identifying and resolving pending Medi-Cal status for patients, and assists with treatment authorization request completion and submission to various prescription plans when medications are not covered.
8. Serves as the point person for patient account revenue integrity and patient requests for refunds or patient account management.
9. Assists the pharmacy leadership with third party payer contracts, billing integrity of pharmacy software system(s) including updating and maintenance of accurate drug prices.
10. Serves as the point person for issues related to cash and accountability/documentation of cash-related payments in the department.
11. Develops and maintains effective partnerships with various AHS departments such as Finance, Information Technology, Materials Management, Engineering, Accounts Payable, Contracts as well as vendors.
12. Responsible for tracking budget spending, designated purchase orders, invoices, expense reimbursement and contract approvals.
13. Utilizes the financial and decision support reporting systems and provides support for the development of budgets, analysis of current and new services, financial reporting, and support for performance improvement, revenue enhancement and cost reduction projects.
14. Assists with coordination of the 340B drug program and AHS 340B compliance policy program.
15. Conducts internal audits for inpatient and outpatient ensuring all operations are compliant with current regulations.
16. Maintains reports regarding tasks such as prior authorization, delivery, lobby wait time and discharge wait time.
17. Assists pharmacy leadership in monitoring productivity and performances based metrics.
18. Serves as the primary point person for check reconciliation and develop and maintain effective partnership with compliance department and third party payers.
Pay Range:$40.02 - $53.63/hr
The pay range for this position reflects the base pay scale for the role at Alameda Health System. Final compensation will be determined based on several factors, including but not limited to a candidate's experience, education, skills, licensure and certifications, departmental equity, applicable collective bargaining agreements, and the operational needs of the organization. Alameda Health System also offers eligible positions a generous comprehensive benefits program.
MINIMUM QUALIFICATIONS:
Required Education: Associate's degree
Preferred Education: Bachelor's degree
Required Experience: One year of recent experience supporting or directly coordinating specialty pharmacy services in an administrative and/or operation role.
Preferred Experience: N/A
Licenses/Certifications: Registered Pharmacy Technician with the California State Board of Pharmacy.
