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Pharmacy Revenue Cycle Program Manager
2 months ago
Description Job Schedule: Full Time Standard Hours: 40 Job Shift: Shift 1 Shift Details: Work where every moment matters.Every day, over 38,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network.The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization.With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system. Position Summary: The Pharmacy Revenue Cycle Manager will play a vital role in overseeing the financial aspects of the pharmacy operations. Your primary responsibility will be to manage the revenue cycle processes, optimize billing and collections, and ensure efficient reimbursement for pharmacy services. Working closely with the pharmacy team, billing specialists, and healthcare providers, you will implement strategies to maximize revenue and maintain compliance with relevant regulations. Position Responsibilities: Key Areas of Responsibility Revenue Cycle Management a. Oversee all aspects of the pharmacy revenue cycle, including billing, claims processing, and collections b. Monitor and analyze revenue cycle metrics, identifying areas for improvement and implementing action plans to enhance safety and accuracy Billing and Claims Processing a. Works with Finance and system revenue cycle departments to ensure appropriate pricing and reimbursement of Pharmacy Services b. Ensure accurate and timely submission of pharmacy claims to third-party payers, including private insurers, CMS Medicare and Medicaid c. Collaborate with billing specialists to resolve claim denials and rejections promptly d. Review coding accuracy and compliance to optimize reimbursement rates Financial Analysis a. Conduct regular financial analyses and generate reports to track revenue performance, identify trends, and make data-driven decisions b. Develop strategies to increase revenue and decrease drug expense c. Be familiar with patient-related finances; understand standard insurance coverage, copayments, and patient financial responsibilities Compliance and Regulations a. Stay up-to-date with relevant healthcare regulations, billing guidelines, and industry best practices b. Ensure compliance with state and federal regulations, payer requirements, and billing standards System Optimization a. Collaborate with IT and pharmacy software vendors to enhance the revenue cycle systems and optimize billing workflows b. Implement and maintain electronic billing processes to streamline operationsQualifications Education Bachelor's degree in Healthcare Administration, Pharmacy, Business, or a related field Experience · Minimum: o In-depth knowledge of pharmacy billing practices, coding systems (e.g., NDC, HCPCS), and insurance reimbursement processes o Familiarity with pharmacy software systems, electronic health records (EHR), and billing software · Preferred: 5+ years in revenue cycle management, preferably in a pharmacy or healthcare setting Language Skills: · Strong communication skills, both written and verbal Knowledge, Skills and Ability: · Knowledge of healthcare compliance and patient and data confidentiality rules We take great care of careers. With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge – helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this isyour moment.
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Pharmacy Revenue Cycle Program Manager
2 months ago
Hartford, United States Hartford Healthcare Full timeWork where every moment matters. Every day, over 38,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network. The creation of the HHC System Support Office recognizes the work of a large and growing...
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Pharmacy Revenue Cycle Program Manager
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Hartford, United States Hartford Healthcare Full timeDescription Job Schedule: Full Time Standard Hours: 40 Job Shift: Shift 1 Shift Details:Work where every moment matters. Every day, over 38,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticuts most comprehensive healthcare network. The...
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