Your Role : Evaluates reimbursement of medications provided to inpatients, clinic patients and patients receiving prescriptions through the outpatient pharmacy network. Works with multidisciplinary groups to develop proper procedures and programs to maximize reimbursement. Facilitates process and system improvements to reduce the likelihood of occurrence of loss of reimbursement relating to pharmaceuticals.
Utilizes data from finance and pharmacy systems to determine reimbursement rates for pharmaceuticals for various patient care settings.
Evaluates actual reimbursement compared to defined contractual reimbursement rates for specific drugs/procedures.
Provides trending on reimbursement and information on areas for focus to maximize reimbursement.
Maintains data in appropriate database to facilitate evaluation and presentation of data.
Evaluates data enabling the identification of trends by multiple variables.
Work with patient accounting, finance, contracts and pharmacy to develop strategy for improved reimbursement.
Maintains list of potential opportunities for reimbursement and contracting based on proactive review of data.
Works collaboratively to develop programs and procedures to maximize reimbursement of pharmaceuticals.
Facilitates process and system improvements to reduce the likelihood of occurrence of loss of reimbursement relating to pharmaceuticals.
Works with pharmacy staff and finance to evaluate reimbursement of new drugs and proposes necessary procedures to maximize reimbursement.
Document enhanced reimbursement from developed programs and trend success of programs.
Utilizing databases maintained to provide documentation to support the effectiveness of the reimbursement program.
Work with Patient Assistance Programs (PAP) to include identifying new opportunities, document receipt of funds and provide proper adjustment of patient accounting accounts.
Collaborates with pharmacy, finance, contracts and patient accounting to identify ongoing opportunities to expand the PAP to reduce drug cost.
Documents savings from the PAP and provides a monthly report trending the savings from the program.
Maintains proper resources and contacts to understand the contractual reimbursement of pharmaceuticals.
Maintains documentation on any issues with contractual reimbursement including the financial impact for review by pharmacy, finance and contracting.
Contributes to the continuing education of pharmacy on the reimbursement of pharmaceuticals and the contractual trends for reimbursement.
Bachelor's Degree (or equivalent experience) and 3 years healthcare reimbursement or pharmacy finance
For more information regarding the physical requirements and environmental conditions for this job, please click here .
Day shift, occasional coverage may be needed until 8pm on weekdays and from 8-12 Saturdays
Discovery Vanderbilt University Medical Center:
Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded and your abilities challenged. It is a place where your diversity -- of culture, thinking, learning and leading -- is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt's mission is to advance health and wellness through preeminent programs in patient care, education, and research.
The Department of Pharmaceutical Services provides comprehensive pharmaceutical care services to Vanderbilt University Hospital (VUH), Monroe Carell Jr. Children's Hospital at Vanderbilt (Children's Hospital), Vanderbilt Psychiatric Hospital (VPH) and The Vanderbilt Medical Group (VMG).
This patient-centered service is provided through the Patient Care Center organization and clinic structure. The role of the Pharmacy is to promote safe and effective medication therapy for all patients and to provide oversight and leadership of the medication use system.
Pharmacist License renewal and professional privilege tax
Flexible Spending Accounts
We encourage you to spend some time reviewing our site to see why
Vanderbilt University Medical Center is one of the top places to work in Nashville -- and the country.
VUMC Recent Accomplishments
Because we are committed to providing the best in patient care, education and research, we are proud of our recent accomplishments:
US News & World Report: #1 Hospital in Tennessee, #1 Health Care Provider in Nashville, #1 Audiology ( Bill Wilkerson Center ), 9 adult and 9 pediatric clinical specialties ranked among the nation's best, #15 Education and Training
Truven Health Analytics: among the top 100 hospitals in the US
Becker's Hospital Review: one of the "100 Greatest Hospitals in America"
The Leapfrog Group: grade "A" in Hospital Safety Score
National Institutes of Health: among the top 10 grant awardees for medical research in the US
American Association for the Advancement of Science: 12 faculty members elected fellows in 2014
Magnet Recognition Program: Vanderbilt nurses are the only group honored in Tennessee
Nashville Business Journal: Middle Tennessee's healthiest employer
American Hospital Association: among the 100 "Most Wired" medical systems in the US
Internal Number: 2003210
About Vanderbilt Health
Vanderbilt University Medical Center is home to Vanderbilt University Hospital, The Monroe Carell Jr. Children’s Hospital at Vanderbilt, the Vanderbilt Psychiatric Hospital and the Vanderbilt Stallworth Rehabilitation Hospital. These hospitals experienced more than 61,000 inpatient admissions during fiscal year 2015. Vanderbilt’s adult and pediatric clinics treated nearly 2 million patients during this same period.Vanderbilt University Hospital and the Monroe Carell Jr. Children’s Hospital at Vanderbilt are recognized again this year by U.S. News & World Report’s Best Hospitals as among the nation’s best with 18 nationally ranked specialties. Vanderbilt University Medical Center is world renowned because of the innovation, work ethic and collegiality of its employees. From our health care advances to our compassionate care, Vanderbilt owes its accomplishments and reputation to staff and faculty who bring skill and drive and innovation to the medical center day after day. World-leading academic departments and comprehensive centers of excellence pursue scientific discoveries and transformational educational and clinical advances across the entire spectrum of health and disease.As th...e largest employer in middle Tennessee, we welcome those who are interested in ongoing development in a caring, culturally sensitive and professional atmosphere. Most of us spend so much of our lives at work, we want to be part of maintaining a workplace in which people support one another and encourage reaching for excellence. Many high-achieving employees stay at Vanderbilt because of the professional growth they experience and because of their appreciation of Vanderbilt’s benefits, public events and discussions, athletic opportunities, beautiful setting and, above all, sense of community and purpose.Vanderbilt and its employees share a set of mutual expectations that have been created with productivity, legality, fairness and safety always in mind. We believe that our investment in training and compensating employees multiplies in value when we enable individuals to deliver their best performance for the benefit of us all.
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