Revenue Cycle Manager

Heritage Specialty Pharmacy

Lincoln (NE)

Hybrid

USD 95,000 - 130,000

Full time

14 days+
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Job summary

Heritage Specialty Pharmacy seeks an experienced Revenue Cycle Manager to lead Admissions and Billing teams and oversee the full patient revenue cycle from referral through reimbursement. The role focuses on optimizing patient access, improving financial performance, and ensuring compliance across specialty pharmacy revenue cycle functions.

You will drive process improvements, collaborate with cross-functional teams, monitor KPIs, and serve as escalation point for complex payer issues.

Qualifications

  • Bachelor's degree in Healthcare Administration, Finance, Accounting, or related field.
  • 7+ years of leadership experience in healthcare billing, reimbursement, revenue cycle, or specialty pharmacy operations.
  • Strong understanding of specialty pharmacy revenue cycle processes and payer requirements.
  • 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.
  • Oversee referral intake, benefits investigations, prior authorizations, patient financial clearance, billing, collections, and reimbursement activities.
  • Monitor and improve KPIs such as cash collections, accounts receivable, claim denials, authorization turnaround times, referral conversion, and reimbursement outcomes.
  • Collaborate with pharmacy, clinical, compliance, IT, accounting, and patient experience teams to improve workflows and patient access to therapy.
  • Serve as an escalation point for complex payer, provider, patient, and reimbursement issues.
  • Drive process improvements, standardization, and automation initiatives that enhance operational and financial performance.
  • Ensure compliance with payer, regulatory, accreditation, and organizational requirements.

Skills

Leadership experience
Communication skills
Problem-solving
Relationship-building

Education

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

Job description

Heritage Specialty Pharmacy is seeking an experienced Revenue Cycle Manager to lead our Admissions and Billing teams and oversee the full patient revenue cycle from referral through reimbursement. This role is responsible for optimizing patient access, improving financial performance, enhancing operational efficiency, and ensuring compliance across specialty pharmacy revenue cycle functions.

Revenue Cycle Manager (Hybrid/Remote)

Heritage Specialty Pharmacy is seeking an experienced Revenue Cycle Manager to lead our Admissions and Billing teams and oversee the full patient revenue cycle from referral through reimbursement. This role is responsible for optimizing patient access, improving financial performance, enhancing operational efficiency, and ensuring compliance 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.
  • Oversee referral intake, benefits investigations, prior authorizations, patient financial clearance, billing, collections, and reimbursement activities.
  • Monitor and improve key performance indicators such as cash collections, accounts receivable, claim denials, authorization turnaround times, referral conversion, and reimbursement outcomes.
  • Collaborate with pharmacy, clinical, compliance, IT, accounting, and patient experience teams to improve workflows and patient access to therapy.
  • Serve as an escalation point for complex payer, provider, patient, and reimbursement issues.
  • Drive process improvements, standardization, and automation initiatives that enhance operational and financial performance.
  • Ensure compliance with payer, regulatory, accreditation, and organizational requirements.
Revenue Cycle Manager Qualifications
  • Bachelor's degree in Healthcare Administration, Finance, Accounting, or related field; equivalent experience considered.
  • 7+ years of leadership experience in healthcare billing, reimbursement, revenue cycle, or specialty pharmacy operations.
  • 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 are committed to providing a level of patient care that few organizations are willing to provide. We combine a high-touch patient experience with operational excellence to help patients access life-changing therapies while supporting providers, caregivers, and payers along the way.

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, and any other protected status under applicable federal, state, and local laws.

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