Director, Finance-Revenue Cycle and Pharmacy
Apply NowCompany: Chase Brexton Health Services
Location: Baltimore, MD 21215
Description:
JOB SUMMARY:
The Director of Finance will have a broad range of responsibilities across all aspects of the company's organizational structure. The Director of Finance will report to the Chief Financial Officer (CFO) and primarily receive assignments from both the (CFO) and the Chief Pharmacy Officer (CPO) but may be called upon to assist with or address issues impacting any area of the organization.
MAJOR DUTIES AND RESPONSIBILITIES:
Strategic Leadership
Through reporting and analysis, identify issues or areas for improvement and work with appropriate stakeholders to develop solutions
Provide strategic and financial leadership to the organization to drive improved operations and financial results
Provide strategic and financial leadership to information technology system upgrades and implementations including financial, medical, and operational systems.
Analytical and Critical Thinking
Prepare financial modeling and analysis to identity opportunities for operational efficiencies and savings
Analyze reimbursements (clinical and pharmacy) to ensure proper reimbursements according to existing contracts and opportunities for improvement
Continuously assess and recommend process improvements to strengthen efficiency and compliance
Compliance, Policy, and Procedure
Evaluate actual and proposed policy changes to project financial impacts to clinical and pharmacy reimbursement
Track and assess 340B revenues, cost savings and purchasing patterns to evaluate compliance risks
Assist with Financial and HRSA audits, ensuring documentation accuracy and preparedness.
Problem Solving and Decision Making
Recommend and/or develop benchmarks for measuring financial and operating performance of assigned responsibilities
Develop forecasting models as needed to assess current operations and potentially new opportunities as to their financial viability
SPECIFIC IDENTIFIED RESPONSIBILITIES (not exhaustive of all duties):
Revenue Cycle
Develop reporting to more clearly identify billing issues (visit owner follow-up, RCM vendor assigned issues, specific procedural billing, etc.)
Develop required relationships with RCM vendor in order to resolve issues as they are identified
Work with existing Finance/Accounting personnel to improve the monthly recording of clinic visits and their associated revenues
Report on and analyze outstanding accounts receivable balances monthly to identify collection issues and concerns
Develop and maintain an accounts receivable reserving methodology and provide adjustments to be included in the monthly financial reporting
Pharmacy
Track and analyze contract pharmacy revenue, cost savings, and wholesale purchasing patterns to assess compliance risks
Analyze pharmacy reimbursement models, including PBMs, contract pharmacies, and drug pricing impact on 340B revenue
Evaluate policy changes affecting 340B and Medicaid reimbursement and forecast financial implications
Collaborate with the Pharmacy, Compliance, and 340B Oversight Council to develop monthly, quarterly, and annual audit metrics
Continuously assess and recommend process improvements to strengthen 340B program efficiency and compliance and assist in evaluating alternative sourcing options to optimize 340B savings in conjunction with Pharmacy management
Maintain detailed documentation of all reports for compliance and audit readiness and assist with HRSA audits, ensuring documentation accuracy and preparedness
SKILLS AND ABILITIES:
Knowledge of finance, accounting, budgeting, and cost control principles
Strong knowledge of 340B program regulations, HRSA compliance requirements, and manufacturer guidance
Knowledge of federal and state financial regulations
Ability to interpret financial impacts of policy changes related to 340B and government reimbursement
Ability to analyze financial data and prepare financial reports, statements and projections using data analytic tools and financial reporting software
EDUCATION AND/OR EXPERIENCE:
Bachelor's degree in Finance, Accounting, Business Administration, Pharmacy, or related field (Master's preferred).
2+ years of experience in 340B program management, pharmacy finance, healthcare finance, or compliance auditing.
Experience with financial modeling, cost analysis, and pharmacy reimbursement methodologies.
WORKING CONDITIONS/PHYSICAL DEMANDS:
Work is typically performed in an office environment.
The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.
The Director of Finance will have a broad range of responsibilities across all aspects of the company's organizational structure. The Director of Finance will report to the Chief Financial Officer (CFO) and primarily receive assignments from both the (CFO) and the Chief Pharmacy Officer (CPO) but may be called upon to assist with or address issues impacting any area of the organization.
MAJOR DUTIES AND RESPONSIBILITIES:
Strategic Leadership
Through reporting and analysis, identify issues or areas for improvement and work with appropriate stakeholders to develop solutions
Provide strategic and financial leadership to the organization to drive improved operations and financial results
Provide strategic and financial leadership to information technology system upgrades and implementations including financial, medical, and operational systems.
Analytical and Critical Thinking
Prepare financial modeling and analysis to identity opportunities for operational efficiencies and savings
Analyze reimbursements (clinical and pharmacy) to ensure proper reimbursements according to existing contracts and opportunities for improvement
Continuously assess and recommend process improvements to strengthen efficiency and compliance
Compliance, Policy, and Procedure
Evaluate actual and proposed policy changes to project financial impacts to clinical and pharmacy reimbursement
Track and assess 340B revenues, cost savings and purchasing patterns to evaluate compliance risks
Assist with Financial and HRSA audits, ensuring documentation accuracy and preparedness.
Problem Solving and Decision Making
Recommend and/or develop benchmarks for measuring financial and operating performance of assigned responsibilities
Develop forecasting models as needed to assess current operations and potentially new opportunities as to their financial viability
SPECIFIC IDENTIFIED RESPONSIBILITIES (not exhaustive of all duties):
Revenue Cycle
Develop reporting to more clearly identify billing issues (visit owner follow-up, RCM vendor assigned issues, specific procedural billing, etc.)
Develop required relationships with RCM vendor in order to resolve issues as they are identified
Work with existing Finance/Accounting personnel to improve the monthly recording of clinic visits and their associated revenues
Report on and analyze outstanding accounts receivable balances monthly to identify collection issues and concerns
Develop and maintain an accounts receivable reserving methodology and provide adjustments to be included in the monthly financial reporting
Pharmacy
Track and analyze contract pharmacy revenue, cost savings, and wholesale purchasing patterns to assess compliance risks
Analyze pharmacy reimbursement models, including PBMs, contract pharmacies, and drug pricing impact on 340B revenue
Evaluate policy changes affecting 340B and Medicaid reimbursement and forecast financial implications
Collaborate with the Pharmacy, Compliance, and 340B Oversight Council to develop monthly, quarterly, and annual audit metrics
Continuously assess and recommend process improvements to strengthen 340B program efficiency and compliance and assist in evaluating alternative sourcing options to optimize 340B savings in conjunction with Pharmacy management
Maintain detailed documentation of all reports for compliance and audit readiness and assist with HRSA audits, ensuring documentation accuracy and preparedness
SKILLS AND ABILITIES:
Knowledge of finance, accounting, budgeting, and cost control principles
Strong knowledge of 340B program regulations, HRSA compliance requirements, and manufacturer guidance
Knowledge of federal and state financial regulations
Ability to interpret financial impacts of policy changes related to 340B and government reimbursement
Ability to analyze financial data and prepare financial reports, statements and projections using data analytic tools and financial reporting software
EDUCATION AND/OR EXPERIENCE:
Bachelor's degree in Finance, Accounting, Business Administration, Pharmacy, or related field (Master's preferred).
2+ years of experience in 340B program management, pharmacy finance, healthcare finance, or compliance auditing.
Experience with financial modeling, cost analysis, and pharmacy reimbursement methodologies.
WORKING CONDITIONS/PHYSICAL DEMANDS:
Work is typically performed in an office environment.
The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.