Description
Information Management/Clinical Function: - Implements computer programs, extracts & formats data and implements creative approaches to PC data management and reporting to meet information needs of department clinicians in a timely manner.
- Performs clinical abstraction from the medical record, collects & inputs essential clinical data to support patient care clinical programs and reports to the appropriate health system committees.
- Formats slide and poster presentations, references & submits manuscripts, and formats professional communication.
- Designs analytical tools in preparing utilization reports for clinical review, i.e., spread sheets, graphs, and budget performance, JCAHO & HEDIS reporting, P&T, ADR, QCCR program, DUE.
- Coordinates health system pharmacy processes in TDS & MIS through development, education, testing & implementation.
- Performs secretarial/clerical duties including correspondence with enrolles, physicians, Pharmacy providers, pharmaceutical manufacturers, and third-party administrators and claim processing vendors. Also, there is a responsibility of preparing educational, newsletter publications, clinical and financial documents for the Pharmacy & Therapeutics committee
Programming: - Defines, develops, and implements computer programs necessary for aggregating information from clinical computer systems and produces this hardcopy and on-line.
- Develops databases for clinical outcomes research and updates tools as needed.
Financial/Accounting: - Manages the P&D for all health system pharmacies & coordinates pricing assignments; monitors departmental revenue analysis & statistical recap and performs all manual charging, interdepartmental workman's corp
- Maintains current provider network information and directory and other record keeping duties
- Coordinates entry of hard copy claims, eligibility and prior approvals as an extension of the TPA help desk.
- Responsible for performing data collection and analysis functions and preparing utilization reports for clinical review.
- Query reports for utilization data to be submitted to physicians, vendors and Healthlink administrators for financial purposes.
- Coordinates distribution of payment to Pharmacy providers.
Organization: - Works with clinical staff to coordinate research and communications orients new personnel to computer & MIS systems.
Requirements: - College degree in accounting, data analysis, computer related field preferred.
- Advanced computer competencies in the following applications: Programming, Database, Word processing, Presentation software, Spreadsheet, Graphics
- Utilizes creative thinking in performance of job responsibilities.
- Familiarity with clinical terminology, services, and processes.
- Experience in preparing education and newsletter publications
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