Clinical Pharmacist – RCM and Contracts
Category: Pharmacy & Clinical
Employment Type: Full Time
Posted Date: April 10, 2025
Job ID: R256445
Location: Hybrid – UT Medical Center, Knoxville, Tennessee, USA
Company: Cencora (Value Apothecaries Inc)
About the Role:
Cencora is looking for a motivated and detail-oriented Clinical Pharmacist to specialize in Revenue Cycle Management (RCM) and Medication Contracting. This role supports medication reimbursement, payer policy management, formulary strategies, and compliance—driving financial performance within pharmacy operations.
Key Responsibilities:
Lead pharmacy initiatives to optimize revenue cycle operations, including billing, charge capture, and denial management.
Collaborate cross-functionally with finance, compliance, and clinical teams for effective reimbursement practices.
Interpret and implement payer contracts to ensure compliance and maximize returns.
Analyze utilization and reimbursement data using benchmarks like WAC, AWP, and ASP.
Ensure 340B program compliance and optimization, when applicable.
Support negotiation and management of medication purchase and payer contracts.
Stay informed on regulatory changes impacting drug billing and reimbursement.
Provide education and guidance to clinical and operations staff on RCM and contract policies.
Education & Qualifications:
Required: PharmD or equivalent from an accredited pharmacy school.
Active pharmacist license in Tennessee or eligibility to obtain.
3–5 years of experience in a health system pharmacy, managed care, or PBM environment.
Strong knowledge of healthcare reimbursement models, payer policies, and drug contracting.
Familiarity with CMS billing, 340B, GPO contracting, and pricing standards (WAC, AWP, ASP).
Strong analytical and communication skills.
Preferred Qualifications:
PGY-1 Residency or advanced education (MBA, MHA, or training in pharmacy admin/health economics).
Experience using Cerner systems.
Background in specialty or infusion pharmacy services.
What Cencora Offers:
Competitive compensation and benefits focused on physical, emotional, and financial wellness.
Support for working families, including backup care, adoption assistance, infertility support, and caregiver leave.
Professional development resources including training, mentorship, employee resource groups, and volunteer opportunities.
Visit: virtualfairhub.com/cencora for more details.
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