Pharmacy Office Manager

Riverside Community Care; Downey (CA); On-site; USD 70,000 - 90,000; Full time

Job summary

A growing closed-door long-term care pharmacy is seeking an experienced Pharmacy Office Manager & Director of Business Operations. This role involves overseeing daily operations, billing management, and team leadership to ensure high-quality service to facility partners. The ideal candidate will have a strategic mindset and hands-on pharmacy billing expertise.

Qualifications

• 3-5 years of experience in LTC pharmacy operations or billing leadership.
• Deep knowledge of LTC pharmacy billing procedures.

Responsibilities

• Oversee daily operations including medication cycle fills and delivery logistics.
• Supervise all aspects of LTC pharmacy billing and manage rejected claims.
• Ensure compliance with HIPAA and other regulations.

Skills

Leadership

Communication

Problem-Solving

Organizational Skills

Education

Associate’s or Bachelor’s degree in Healthcare Administration

Tools

FrameworkLTC

DocuTrack

QS/1

PioneerRx

Job description

Job Summary

Oncare Pharmacy, a growing closed-door long-term care pharmacy serving assisted living facilities, is seeking an experienced and driven Pharmacy Office Manager & Director of Business Operations. This dual-role leadership position oversees daily administrative, billing, and operational workflows to ensure the pharmacy delivers timely, compliant, and high-quality service to its facility partners. The ideal candidate is a strategic thinker with hands-on pharmacy billing expertise and an understanding of LTC pharmacy operations.

Key Responsibilities

1. Operational & Administrative Oversight
   • Direct daily operations including medication cycle fills, facility coordination, delivery logistics, and workflow optimization.
   • Oversee scheduling, inventory coordination, and internal communications to support accurate and timely dispensing.
   • Act as a primary liaison between the pharmacy and LTC facility staff including DONs, administrators, and care coordinators.
   • Lead implementation and refinement of pharmacy workflows, ensuring standard operating procedures (SOPs) are followed and updated regularly.
2. Billing & Insurance Management
   • Supervise all aspects of LTC pharmacy billing, including claim submission to Medicare Part D, Medicaid, and commercial payers.
   • Proactively manage rejected claims, prior authorizations, patient copays, and facility-specific billing nuances.
   • Ensure accuracy and timeliness of billing cycles, EOB reconciliation, and third-party payer communications.
   • Stay current with CMS regulations, billing updates, and PBM contractual requirements.
3. Team Leadership & Staff Management
   • Supervise, mentor, and evaluate pharmacy administrative staff, including billing team members, delivery coordinators, and data entry technicians.
   • Lead hiring, onboarding, and performance reviews of support personnel.
   • Promote a positive, accountable work culture focused on quality, communication, and service excellence.
4. Compliance & Regulatory Affairs
   • Ensure compliance with HIPAA, pharmacy board, DEA, CMS, and LTC-specific regulations.
   • Maintain audit-ready documentation including controlled substance logs, facility authorizations, and insurance records.
   • Support internal audits and external inspections from PBMs and regulatory bodies.
5. Business Strategy & Growth
   • Analyze operational metrics and billing trends to identify inefficiencies and growth opportunities.
   • Assist ownership in developing strategies for facility acquisition, service expansion, and cost containment.
   • Build and maintain strong relationships with current and prospective LTC partners.
   • Collaborate with pharmacy leadership on strategic planning, business development, and KPI tracking.

Qualifications

• Associate’s or Bachelor’s degree in Healthcare Administration, Business, Pharmacy Technology, or related field (required).
• Minimum 3–5 years of experience in LTC pharmacy operations, office management, or billing leadership.
• Deep knowledge of LTC pharmacy billing procedures, Medicare Part D/Medicaid claims, and prior authorizations.
• Proficiency with LTC pharmacy platforms (e.g., FrameworkLTC, DocuTrack, QS/1, PioneerRx, etc.).
• Proven leadership and staff management experience, preferably in a pharmacy or healthcare environment.
• Strong communication, problem-solving, and organizational skills.
• High attention to detail, accountability, and ability to thrive in a fast-paced environment.

Preferred Traits

• LTC billing certification or advanced knowledge of pharmacy reimbursement models.
• Experience managing pharmacy operations during monthly cycle fills.
• Ability to lead continuous improvement projects and adapt to changing regulatory requirements.

Working Conditions

• On-site in a closed-door pharmacy setting with regular interaction with pharmacy and LTC facility staff.
• May require extended hours during monthly cycle fills or audit periods.
• Occasional lifting of medication totes, packaging materials, or office supplies.

Pay scale: $70,000 to $90,000 per year.

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.