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Job Details
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
- 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.
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.
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.
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.
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.
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