Strategic Pharmacy Revenue Cycle Leader

Medical University Hospital Authority (MUHA)

United States

On-site

USD 110,000 - 160,000

Full time

2 days ago
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Job summary

Medical University Hospital Authority (MUHA) seeks a Pharmacy Revenue Cycle Manager to lead revenue cycle and revenue integrity activities across the health system, focusing on charge capture, billing, reimbursement, reconciliation, and financial reporting. You will collaborate with Pharmacy, Revenue Cycle, Finance, and Compliance to reduce leakage and ensure payer compliance.

The role requires strong leadership, experience in healthcare revenue cycle, and proficiency with Excel and healthcare

Qualifications

  • Degree in Pharmacy, Finance, Accounting, Business Administration, Healthcare Administration, or a related field.
  • Five years of progressive experience in pharmacy operations, healthcare revenue cycle, revenue integrity, reimbursement, billing, finance, or healthcare analytics.
  • Experience with medication charging, billing, reimbursement analysis, financial reporting, or revenue reconciliation.
  • Demonstrated supervisory, team leadership, or cross-functional project leadership experience.
  • Proficiency with Microsoft Excel and healthcare financial or reporting systems.
  • Active pharmacist licensure when required by the position's scope.

Responsibilities

  • Lead pharmacy revenue cycle activities across hospital, ambulatory, infusion, specialty, retail, and clinic-based services.
  • Oversee medication charge capture, billing validation, claim reconciliation, payment variance review, denial analysis, and reimbursement monitoring.
  • Identify and address lost revenue, underpayments, duplicate charges, billing errors, write-offs, and other financial leakage.
  • Maintain controls supporting accurate medication pricing, coding, documentation, billing, and reimbursement.
  • Partner with Pharmacy Informatics and Information Solutions to maintain medication billing configurations, charge codes, units of measure, and system logic.
  • Coordinate reviews of HCPCS codes, National Drug Codes, revenue codes, payer requirements, and supporting documentation.
  • Evaluate the financial impact of new medications, high-cost therapies, formulary decisions, payer changes, and manufacturer programs.
  • Develop dashboards and key performance indicators for revenue, denials, underpayments, charge accuracy, reimbursement, and financial recoveries.
  • Support revenue cycle activities related to specialty pharmacy, infusion services, medication management, patient assistance, and 340B operations.
  • Lead root-cause analyses and corrective-action plans for recurring billing and reimbursement issues.
  • Develop policies, procedures, workflows, audit tools, reporting standards, and internal controls.
  • Prepare executive reports and recommendations for pharmacy and organizational leadership.
  • Lead, coach, and develop assigned revenue cycle and revenue integrity staff.

Skills

Excel
Financial reporting
Reimbursement analysis
Revenue cycle

Education

Bachelor's degree in Pharmacy, Finance, Accounting, Business Administration, Healthcare Administration, or a related field
PharmD, MBA, MHA, Master of Finance, or another relevant advanced degree

Tools

Epic
Willow
Workday
Power BI
Tableau

Job description

Medical University Hospital Authority (MUHA) seeks a Pharmacy Revenue Cycle Manager to lead revenue cycle and revenue integrity activities across the health system, focusing on charge capture, billing, reimbursement, reconciliation, and financial reporting. You will collaborate with Pharmacy, Revenue Cycle, Finance, and Compliance to reduce leakage and ensure payer compliance.

The role requires strong leadership, experience in healthcare revenue cycle, and proficiency with Excel and healthcare

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