Billings Clinic Business Analyst - Specialty Pharmacy in Billings, Montana
You can make a difference as a part of our region's largest health care system, based locally in Billings, Montana. Join our amazing team with a focus on safe, high quality care and an excellent patient experience. Billings Clinic is here to take care of our community and region.
We look forward to meeting you.
Billings Clinic is a community-owned, not-for-profit, Physician-led health system based in Billings with more than 4,700 employees, including over 550 physicians and non-physician providers. Our integrated organization consists of a multi-specialty group practice and a 304-bed hospital. Learn more about Billings Clinic (our organization, history, mission, leadership and regional locations) and how we are recognized nationally for our exceptional quality.
We provide a comprehensive and competitive benefits pa
e to all full-time employees (minimum of 24 hours/week), including Medical, Dental, Vision, 403(b) Retirement Plan with employer matching, Defined Contribution Pension Plan, Paid Time Off, employee wellness program, and much more. Click here for more information or download the 2021 Employee Benefits Guide.
Billings Clinic is proud to be recognized for nursing excellence as a Magnet?-designated organization, joining only 97 other organizations worldwide that have achieved this honor four times. The re-designation process happens every four years. Click here to learn more!
s Analyst - Specialty Pharmacy
SPECIALTY PHARMACY (Specialty Pharmacy)
Full-Time (.75 or greater)
Hours per Pay Period:
1.00 = 80 hours
Starting Wage DOE:
$22.87 - $29.50
Works effectively with Pharmacy Leadership Team, Information Technolo
gy, and Finance Depa
rtments to plan, organize, facilitate, and monitor the activities and functions of the pharmacy financial operations. The Pharmacy Business Analyst will be responsible to provide the financial leadership and direction for the assigned pharmacy division(s), including inpatient and outpatient, to ensure continuity and consistency across and throughout departments and in the region. Ensures the delivery of cost-effective health care services in line with the Billings Clinic mission, vision, values, and goals. Accountabilities include strategic financial planning and new program development directly related to the Pharmacy Department, fiscal control, and responsibility to manage revenue and costs, and financial process improvement.
Essential Job Functions
• Supports and models behaviors consistent with Billings Clinic’s mission, vision, values, code of business conduct and service expectations. Meets all mandatory organizational and departmental requirements. Maintains competency in all organizational, departmental and outside agency standards as it relates to the environment, employee, patient safety or job performance.
• Understands the overall workflow to proactively solve problems, provide analysis, and evaluate trends in the revenue cycle. Displays initiative to resolve 835 remittance issues including, but not limited to: unapplied cash, claim exceptions, and partial pays. Provide claims resolution to ensure accuracy in the process.
• Assists with in
ventory, supply and equipment acquisition and repair, and vendor relations.
• Conducts performance and payment audits for both internal and external audits. Supervises the collection of payment data and provides recommendations and resolution to audit results. Attends, reviews, does research, and responds to payer audits. Develops audit responses and correspondences with payer and escalates adverse audits to management.
• Provides proactive and ongoing follow-up and problem solving with insurance companies and pharmacy sites to identify trends, communicate proactively, and ensure accuracy in the revenue cycle process.
• Ensures optimal revenue cycle performance through evaluation, analysis, and problem solving. Provides analysis to stakeholders and constantly analyzes operations in an attempt to improve processes in order to provide better customer service and improve the revenue cycle.
• Reviews payments for accuracy, ensure collection according to contracts, and follows-up with insurance companies to leverage the revenue process.
• Oversees the creation of analysis consisting of proformas, IRR’s, capital requests, and business line opportunities.
• Collect and analyze da
ta for fiscal impact of exis
ting and proposed contracts, business lines, and product lines for both internal and external customers. Provide analysis, recommendations, and summary to stakeholders
• Understands contracts to achieve results and department metrics, including but not limited to: payer DSO equal or exceeds department goals, A/R percentage over 60 days equals or exceeds department goals, and timely submission of secondary payer billings equals or exceeds department goals.
• Maintains competency in all organizational, departmental, and outside agency environmental, employee or patient safety standards relevant to job performance.
• Performs other duties as assigned or needed to meet the needs of the department/organization.
Knowledge, Skills, and Abilities
• Billings Clinic policies and procedures, both organizational and departmental
• Billings Clinic Code of Business Conduct
• Billings Clinic Corporate Compliance Program
2022; Customer service technique
s and Personal Service Excellence (PSE) skills
• HIPAA and confidentiality requirements
• Regulatory, legal and accreditation standards, guidelines and regulations
• Health care environments and trends as it relates to pharmacy
• Budgeting and fiscal controls
• Inventory management
• Information systems and Microsoft Office programs
• Change management theories and principles
• Health care information management
• Management and leadership principles
• Government and third-party insurance reimbursement methodologies
• Application of leader
• Budgeting and fiscal controls
• Accounting principles
• Meticulous focus on the financial process improvement and optimizing operations
• Investigating the revenue cycle of pharmacy to maximize the revenue stream
• Utilization of personal computer and Microsoft Office programs (i.e., Windows, Outlook, Word, Excel, Access, PowerPoint, etc
• Professional communication skills, both written and verbal.
• Time management, organization, and prioritization
• Use of performance improvement techniques
• Group facilitation
• Statistics, data collection, analytical tools, and report writing
• Conflict res
• Facilitating change management
• Lean and Six Sigma principles
• Incorporate population specific needs into all aspects of communication and patient care; scope of services provided will encompass age groups ranging from infant through geriatric
• Establish and maintain effective working relationships
; Interpret policies and procedures; ident
ify non-compliance and take appropriate action
• Utilize time management concepts to maximize time effectively
• Work independently
• Utilize interpersonal skills to interact effectively with employees, leadership, physicians, board, and external audiences
• Facilitate group dynamics, create enthusiasm, and encourage teamwork among diverse members of a group
#x2022; Process meaningful reports that reflect best use of data, statistical analysis, and trending graphics
• Provide visionary thinking and processes which are outside the traditional methods and standards
• Work effectively in a team environment
• Work with frequent interruptions and competing priorities and maintains flexibility to adapt to a variety of workload assignments
• Decisions regarding budgeting and fiscal control have
direct impact to the financial viability of th
• Develops measurement processes and reports that are of serious importance to the organization
• Has access to and stewardship of considerable confidential information in supporting the strategic initiatives of the organization as well as quality and risk performance information
• Requires frequent interaction with administration, medical staff, management, employees, and external organizational relationships, attorneys, and customers.
• Bachelor’s degree in business, economics, or related field, required.
e="color: black; font-size: 10pt; font-family: Ari
al, sans-serif;">• Master’s degree in business or healthcare administration, preferred.
• Three (3) years’ experience in business operations and financial process improvement.
Billings Clinic is Montana’s largest health system serving Montana, Wyoming and the western Dakotas. A not-for-profit organization led by a physician CEO, the health system is governed by a board of community members, nurses and physicians. Billings Clinic includes an integrated multi-specialty group practice, tertiary care hospital and trauma center, based in Billings, Montana. Learn more at www.billingsclinic.com/aboutus
Billings Clinic is committed to being an inclusive and
welcoming employer, that strives to be kind, safe, and courageous in all we do.
As an equal opportunity employer, our policies and processes are designed to
achieve fair and equitable treatment of all employees and job applicants. All
employees and job applicants will be provided the same treatment in all aspects
of the employment relationship, regardless of race, color, religion, sex,
gender identity and expression, sexual orientation, pregnancy and family
status, national origin, spoken language, neurodiversity, age, and/or disability.
To ensure we provide an accessible candidate experience for prospective
employees, please let us know if you need any accommodations during the