Pharmacy Reimbursement & Revenue Optimization Lead

bilh; United States; On-site; USD 95,000 - 130,000; Full time

Job summary

Beth Israel Lahey Health is seeking a Manager, Pharmacy Reimbursement to lead reimbursement operations for a pharmacy enterprise generating approximately $300 million in annual revenue.

The role focuses on optimizing revenue, overseeing rebates and Medicare Maximum Fair Price (MFP) processes, and partnering with Pharmacy Operations, Finance, Revenue Cycle, 340B, Compliance, and Informatics to drive financial performance and strategic growth.

Qualifications

• Minimum seven (7) years of progressive experience in pharmacy finance, healthcare finance, reimbursement, revenue cycle, revenue integrity, or related disciplines.
• Minimum three (3) years of leadership or management experience.
• Demonstrated experience developing financial analyses and executive-level reporting.

Responsibilities

• Lead pharmacy revenue cycle operations, including billing, charge capture, reimbursement, denials management, and accounts receivable performance.
• Develop and implement strategies to optimize revenue, improve collections, reduce revenue leakage, and enhance cash flow.
• Oversee manufacturer rebate programs and Medicare Maximum Fair Price (MFP) financial processes to maximize reimbursement and financial performance.
• Partner with Pharmacy Operations, Finance, Revenue Cycle, 340B, Compliance, and Informatics teams to support operational and growth initiatives.
• Monitor revenue integrity, reimbursement trends, and key performance indicators, providing actionable insights and recommendations.
• Develop executive-level financial reports, dashboards, forecasts, and analyses to support decision-making and strategic planning.
• Recruit, develop, and lead revenue cycle staff while fostering a culture of accountability, service excellence, and continuous improvement.

Skills

Pharmacy finance

Revenue cycle

Leadership

Financial modeling

Excel / BI

Education

Bachelor's degree in Finance, Accounting, Healthcare Administration, Business Administration, Pharmacy, or a related field

Job description

Beth Israel Lahey Health is seeking a Manager, Pharmacy Reimbursement to lead reimbursement operations for a pharmacy enterprise generating approximately $300 million in annual revenue.

The role focuses on optimizing revenue, overseeing rebates and Medicare Maximum Fair Price (MFP) processes, and partnering with Pharmacy Operations, Finance, Revenue Cycle, 340B, Compliance, and Informatics to drive financial performance and strategic growth.