Pharmacy Revenue Optimization Analyst

Beth Israel Lahey Health; Westwood (MA); Sur place; USD 72 000 - 96 000; Plein temps

Résumé du poste

Beth Israel Lahey Health is seeking a Pharmacy Reimbursement Analyst to support the financial performance of the health system's pharmacy enterprise. You will analyze reimbursement, denials, underpayments, and accounts receivable trends, and develop dashboards tracking payer trends and key financial indicators.

You'll collaborate with Pharmacy Operations, Finance, and IS teams to optimize reimbursement, perform rebate reconciliations, and stay current on Medicare and payer policy changes.

Qualifications

• Bachelor's degree in Finance, Business, Healthcare Administration, Pharmacy Administration, or related field.
• 3+ years of healthcare revenue cycle, pharmacy finance, specialty pharmacy, infusion reimbursement, or healthcare analytics experience.
• Advanced Excel and data analytics skills with the ability to translate complex data into actionable insights.
• Strong analytical, organizational, problem-solving, and project management skills.

Responsabilités

• Analyze pharmacy reimbursement, denials, underpayments, and accounts receivable trends to identify revenue recovery and optimization opportunities.
• Perform analytics, rebate reconciliation, dispute management, and financial performance reporting.
• Analyze 340B and MFP rebate eligibility, reimbursement, and payment variances; prepare appeals and disputes to ensure accurate rebate capture.
• Investigate payer denials and underpayments, prepare appeals, and coordinate resolution with payers and internal stakeholders.
• Develop dashboards and reports tracking reimbursement performance, denials, rebates, payer trends, and key pharmacy financial indicators.
• Collaborate with pharmacy leadership, finance, contracting, and revenue cycle teams to improve operational and financial outcomes.

Connaissances

Data analytics

Advanced Excel

Problem solving

Project management

Formation

Bachelor's degree in Finance/Business/Healthcare Administration/Pharmacy Administration

Description du poste

Beth Israel Lahey Health is seeking a Pharmacy Reimbursement Analyst to support the financial performance of the health system's pharmacy enterprise. You will analyze reimbursement, denials, underpayments, and accounts receivable trends, and develop dashboards tracking payer trends and key financial indicators.

You'll collaborate with Pharmacy Operations, Finance, and IS teams to optimize reimbursement, perform rebate reconciliations, and stay current on Medicare and payer policy changes.