Senior Pharmacy Reimbursement Analyst

bilh; United States; On-site; USD 72,000 - 96,000; Full time

Job summary

Beth Israel Lahey Health is seeking a Pharmacy Reimbursement Analyst to support the financial performance of our health system pharmacy enterprises. You will analyze reimbursement, denials, rebates, and revenue cycle metrics across specialty, infusion, retail, and provider-administered services, partnering with operations, finance, and IS teams.

You will develop dashboards, track payer trends, and lead appeals and disputes to maximize revenue recovery while staying current on 340B and Medicare

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.
• Demonstrated ability to manage multiple priorities while maintaining attention to detail and accuracy.

Responsibilities

• Analyze 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 within pharmacy systems; prepare and submit appeals and disputes to manufacturers, payers, and third-party administrators to ensure accurate rebate capture and revenue recovery.
• Investigate payer denials and underpayments, prepare appeals, and coordinate resolution with payers and internal stakeholders.
• Support medication charge capture, reimbursement integrity, and pharmacy revenue cycle process improvements.
• 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.
• Stay current on pharmacy reimbursement regulations, payer policies, 340B requirements, and Medicare reimbursement changes.

Skills

Advanced Excel

Data analytics

Financial analysis

Project management

Education

Bachelor's degree in Finance, Business, Healthcare Administration, Pharmacy Administration, or related field

Job description

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives.

Job Description:

The Pharmacy Reimbursement Analyst, under the direction of the Manager, Pharmacy Reimbursement, supports the financial performance of a large health system pharmacy enterprise by analyzing reimbursement, billing, revenue cycle operations, and payer performance across specialty pharmacy, infusion, retail, and provider-administered drug services. This role partners with Pharmacy Operations, Finance, and Information Systems teams to optimize reimbursement, ensure revenue integrity, and identify revenue enhancement opportunities.

Essential Responsibilities:

• 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 within pharmacy systems; prepare and submit appeals and disputes to manufacturers, payers, and third-party administrators to ensure accurate rebate capture and revenue recovery.
• Investigate payer denials and underpayments, prepare appeals, and coordinate resolution with payers and internal stakeholders.
• Support medication charge capture, reimbursement integrity, and pharmacy revenue cycle process improvements.
• 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.
• Stay current on pharmacy reimbursement regulations, payer policies, 340B requirements, and Medicare reimbursement changes.

Required 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.
• Demonstrated ability to manage multiple priorities while maintaining attention to detail and accuracy.

Pay Range:

$72,000.00 USD - $96,000.00 USD

The pay range listed for this position is the annual base salary range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law.

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled