Revenue Cycle Manager

Heritage Specialty Pharmacy; Lee's Summit (MO); Hybrid; USD 110,000 - 150,000; Full time

Job summary

Heritage Specialty Pharmacy is seeking an experienced Revenue Cycle Manager to lead the Admissions and Billing teams and oversee the full revenue cycle from referral through reimbursement. The role focuses on optimizing patient access for high-cost therapies, reducing denials, and improving reimbursement outcomes.

You will collaborate with pharmacy operations, clinical teams, IT, compliance, and payer relations to streamline workflows, track KPIs, and drive standardization and automation.

Qualifications

• Bachelor's degree in Healthcare Administration, Finance, Accounting, or related field; equivalent experience considered.
• 7+ years of leadership experience in specialty pharmacy billing, reimbursement, revenue cycle, or specialty pharmacy operations (strongly preferred).
• Strong understanding of specialty pharmacy and/or infusion revenue cycle processes, payer requirements, prior authorizations, and reimbursement.
• Experience managing teams, performance metrics, and operational improvement initiatives.
• Excellent communication, problem-solving, and relationship-building skills.

Responsibilities

• Lead the Admissions and Billing teams, providing coaching, accountability, and professional development, maintaining a high-performing, patient-focused culture.
• Oversee the full revenue cycle, including referral intake, benefits investigations, prior authorizations, patient financial clearance, billing, collections, and reimbursement activities, ensuring timely access to therapy and optimal financial outcomes.
• Monitor, analyze, and improve key performance indicators (KPIs), including cash collections, days in accounts receivable, claim denials, authorization turnaround times, referral conversion, and reimbursement outcomes.
• Collaborate with pharmacy operations, clinical teams, compliance, IT, accounting, and patient experience teams to streamline workflows and patient access to therapy, improving the overall patient experience.
• Serve as the primary escalation point for complex payer, provider, patient, and reimbursement issues, driving timely and effective resolutions.
• Drive process improvements, standardization, and automation initiatives that enhance operational and financial performance.
• Ensure compliance with payer requirements, accreditation standards (URAC, ACHC, etc.), HIPAA, and all applicable regulatory and organizational policies.

Skills

Leadership

Revenue cycle

Specialty pharmacy

Billing

Payer requirements

Education

Bachelor's degree in Healthcare Administration or related field

Job description

Revenue Cycle Manager - Specialty Pharmacy (Hybrid/Remote)

Heritage Specialty Pharmacy is seeking an experienced Revenue Cycle Manager to lead our Admissions and Billing teams and oversee the full specialty pharmacy revenue cycle from referral through reimbursement. This role plays a critical role in supporting patients with complex, high-cost therapies by optimizing patient access, improving reimbursement outcomes, reducing denials, and ensuring operational excellence across specialty pharmacy revenue cycle functions.

What the Revenue Cycle Manager Will Do

• Lead the Admissions and Billing teams, providing coaching, accountability, and professional development, maintaining a high-performing, patient-focused culture.
• Oversee the full revenue cycle, including referral intake, benefits investigations, prior authorizations, patient financial clearance, billing, collections, and reimbursement activities, ensuring timely access to therapy and optimal financial outcomes.
• Monitor, analyze, and improve key performance indicators (KPIs), including cash collections, days in accounts receivable, claim denials, authorization turnaround times, referral conversion, and reimbursement outcomes.
• Collaborate with pharmacy operations, clinical teams, compliance, IT, accounting, and patient experience teams to streamline workflows and patient access to therapy, improving the overall patient experience.
• Serve as the primary escalation point for complex payer, provider, patient, and reimbursement issues, driving timely and effective resolutions.
• Drive process improvements, standardization, and automation initiatives that enhance operational and financial performance.
• Ensure compliance with payer requirements, accreditation standards (URAC, ACHC, etc.), HIPAA, and all applicable regulatory and organizational policies.

Revenue Cycle Manager Qualifications

• Bachelor's degree in Healthcare Administration, Finance, Accounting, or related field; equivalent experience considered.
• 7+ years of leadership experience in specialty pharmacy billing, reimbursement, revenue cycle, or specialty pharmacy operations (strongly preferred).
• Strong understanding of specialty pharmacy and/or infusion revenue cycle processes, payer requirements, prior authorizations, and reimbursement.
• Experience managing teams, performance metrics, and operational improvement initiatives.
• Excellent communication, problem-solving, and relationship-building skills.

Why Heritage?

At Heritage Specialty Pharmacy, we help patients gain access to life-changing specialty therapies through a combination of clinical care, patient advocacy, and reimbursement expertise. Our team partners closely with providers, payers, and caregivers to navigate the complex specialty medication journey. This role offers the opportunity to lead a growing operation, improve patient access to critical therapies, and directly influence both patient outcomes and financial performance.

If you're passionate about leading teams, improving patient access, and driving meaningful operational results, we'd love to hear from you.

Heritage Specialty Pharmacy is an Equal Opportunity Employer. We are committed to creating a diverse and inclusive workplace and welcome applicants from all backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age, disability, genetic information, veteran status, or any other protected status under applicable federal, state, and local laws.