Pharmacy Reimbursement Analyst IV - 141389

University of California - San Diego Medical Centers; San Diego (CA); On-site; USD 91,000 - 166,000; Full time

Job summary

The University of California - San Diego Medical Centers in San Diego, CA seeks a senior analyst to lead projects and teams, identify opportunities to improve revenue capture, and perform analysis at the highest level of scope and complexity.

Responsibilities include applying advanced knowledge of reimbursement workflows, financial reporting, data management, and cross‑functional collaboration to optimize profitability, reduce risk, and drive process improvements within a complex healthcare

Qualifications

• Nine (9) years of related experience, education/training, OR a Bachelor's degree in related area plus five (5) years of related experience/training.
• Maintains advanced knowledge in healthcare reimbursement revenue cycle workflow, financial reporting concepts and industry best practices.
• Comprehensive knowledge of relevant department, medical center, and UC policies and processes.
• Advanced skills in data management and analysis.
• Project management skills to lead a team and see projects through from inception to completion on schedule.
• Advanced knowledge of financial analysis, research, and reporting related to reimbursement in healthcare settings.
• Advanced interpersonal and communications skills for cross-functional collaboration.
• Advanced knowledge of organization's Reimbursement Healthcare application programs to troubleshoot issues and improve efficiency.

Responsibilities

• Lead projects and/or team members, identify opportunities to improve revenue capture, and perform analysis at the highest level of scope and complexity.
• Apply advanced data analysis, reporting, and BI methods to drive financial insights and decision-making.
• Collaborate with multiple departments to ensure accurate financial reporting and effective reimbursement strategies.

Skills

Data analysis

Reporting

Business intelligence

Revenue cycle

Margin optimization

Profitability reporting

Project management

Process improvement

Interpersonal skills

Education

Bachelor's degree

Tools

Power BI

Tableau

SQL

Excel (Pivot Tables)

Power Query

Data modeling

Epic Reporting Workbench

Job description

DESCRIPTION

Leads projects and/or team members, identifies opportunities to improve effectiveness of revenue capture, and performs analysis at the highest level of scope and complexity.

MINIMUM QUALIFICATIONS

• Nine (9) years of related experience, education/training, OR a Bachelor's degree in related area plus five (5) years of related experience/training. Related experience includes a combination of: Data analysis, reporting, and business intelligence, revenue cycle, margin optimization, profitability reporting, project management and process improvement initiatives.
• Maintains advanced knowledge in healthcare reimbursement revenue cycle workflow, financial reporting concepts and industry best practices. Proven ability to apply knowledge and skills to identify improvements.
• Comprehensive knowledge of relevant department, medical center, and UC policies and processes. Ability to apply policy knowledge to proactively identify potential risk areas.
• Advanced skills in data management and analysis.
• Project management skills to lead a team, prioritize personal and team tasks and see projects through from inception to completion on schedule. Demonstrates adaptability and flexibility to effectively handle change.
• Advanced knowledge of financial analysis, research, and reporting, particularly as it applies to reimbursement in healthcare settings.
• Advanced interpersonal skills, with the ability to collaborate effectively on highly-complex projects in a team environment with a wide variety of business and clinical areas.
• Advanced communications skills, with the ability to interpret and convey complex clinical finance information in a clear, concise manner. Ability to prepare compelling and informative reports and presentations to all levels of staff and management.
• Advanced knowledge of organization's Reimbursement Healthcare application programs to troubleshoot issues and recommend improvements in convenience and efficiency.

PREFERRED QUALIFICATIONS

• Advanced proficiency in Microsoft Excel, including Pivot Tables, Power Query, data modeling, and complex formulas.
• Experience with data visualization and business intelligence tools such as Power BI, Tableau
• Working knowledge of SQL and database querying.
• Lean Six Sigma, project management, or other process improvement training/certification preferred.
• Epic Reporting Workbench experience.
• Pharmacy reimbursement analytics experience.
• Drug utilization / financial analysis experience.

SPECIAL CONDITIONS

• Must be able to work various hours and locations based on business needs.
• Employment is subject to a criminal background check and pre-employment physical.

Pay Transparency Act

Annual Full Pay Range: $90,600 - $166,400 (will be prorated if the appointment percentage is less than 100%)

Hourly Equivalent: $43.39 - $79.69

Factors in determining the appropriate compensation for a role include experience, skills, knowledge, abilities, education, licensure and certifications, and other business and organizational needs. The Hiring Pay Scale referenced in the job posting is the budgeted salary or hourly range that the University reasonably expects to pay for this position. The Annual Full Pay Range may be broader than what the University anticipates to pay for this position, based on internal equity, budget, and collective bargaining agreements (when applicable).