Sr Project Coordinator, Pharmacy Reimbursement (Hybrid)

A Brief Overview The Senior Project Coordinator, Pharmacy serves as a key operational and strategic resource supporting hospital outpatient department (HOPD) medication reimbursement and denial prevention initiatives. This role is responsible for coordinating the review and resolution of medication-related billing denials, analyzing denial trends to identify root causes and targeted opportunities for denial reduction, and developing data-driven recommendations to improve reimbursement outcomes.

The Senior Project Coordinator partners closely with Pharmacy Services, Revenue Cycle, and Precertification teams to ensure alignment of processes, facilitate communication, and support timely authorization and billing workflows. Additionally, this role leads the development and implementation of proactive medical necessity review services, helping to optimize documentation, coding, and payer compliance while reducing financial risk and improving patient access to medication therapy.

Manages all aspects of quality measurement and improvement projects. Collaborates with pharmacy leaders on project methodologies, leads coordination of data collection and analysis and assures projects are completed according to plan. Coordinates work and communicates across departments within UH and with external customers including, but not limited to, health-system related vendors.

Serves as a lead and mentor to Project Coordinators.

The Senior Project Coordinator is responsible for coordination and implementation of quality measurement and improvement, evaluation, and projects. Works closely with the Pharmacy Leadership Team to assist in the development of project methodologies and manage components of the project and implementation plans as assigned. Develop, coordinate, and lead a portfolio of activities including, but not limited to: regulatory matters, writing protocols, creating operations manuals, and data collection.

Manage and coordinate regulatory requirements as needed. Collaborate effectively with various departments and associates by facilitating projects across the University Hospitals business. Provide timely and concise communications to the leadership team regarding project status.

Lead coordination of primary data collection, and oversee compilation and analysis of secondary datasets (when applicable). Serve as lead support on projects and assignments, which require commitment from interdepartmental and external resources. Manage and report on project timelines according to project assignments and corresponding deadlines.

Manage engagements with external customers and health system-related vendors. Coordinate activities with colleagues within the UHHS network and other project collaborators. Provide leadership, mentorship, and education for team members on assigned projects.

Additional Responsibilities Performs other duties as assigned. Complies with all policies and standards. For specific duties and responsibilities, refer to documentation provided by the department during orientation.

Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace. Education Bachelor's Degree in business, finance, healthcare administration, or similar field (Required) Work Experience 5+ years Experience in a healthcare setting (Required) and Experience working in a fast-paced environment and adapting to changing priorities on a deadline (Required) and Project management experience (Preferred) Knowledge, Skills, & Abilities Demonstrated knowledge of HOPD billing, medication reimbursement processes, medical necessity criteria, and payer authorization guidelines Experience analyzing denial trends, identifying root causes, and implementing process improvement initiatives that improve reimbursement outcomes and reduce denials.

Experience working collaboratively with pharmacy, revenue cycle, finance, patient access, precertification, and clinical teams. Proficiency in data analysis and reporting tools, with the ability to translate complex data into actionable recommendations for operational and financial improvement. Strong organizational skills with the ability to prioritize competing demands and work independently in a fast-paced healthcare environment.

Demonstrated ability to achieve results both independently and working with a team (Required proficiency) Excellent problem-solving and decision-making skills (Required proficiency) Excellent writing ability and communication skills (Required proficiency) Advanced computer skills including MS Office products, and internet applications (Required proficiency) Regulatory experience achieving IRB approval for studies (Required proficiency) Excellent interpersonal skills and the ability to work with individuals at all levels of an organization (Required proficiency) Physical Demands Standing Occasionally Walking Occasionally Sitting Constantly Lifting Rarely 20 lbs Carrying Rarely 20 lbs Pushing Rarely 20 lbs Pulling Rarely 20 lbs Climbing Rarely 20 lbs Balancing Rarely Stooping Rarely Kneeling Rarely Crouching Rarely Crawling Rarely Reaching Rarely Handling Occasionally Grasping Occasionally Feeling Rarely Talking Constantly Hearing Constantly Repetitive Motions Frequently Eye/Hand/Foot Coordination Frequently Travel Requirements 5% Local travel to UH sites