Sr. Manager, Pharmacy Revenue Cycle Management

Company Overview:

Founded in 1985, SelectQuote (NYSE: SLQT) provides solutions that help consumers protect their most valuable assets: their families, health and property. SelectRX, a subsidiary of SelectQuote, is prioritizing important population health initiatives focused on actively managed, high-touch patient experience by improving patient engagement and health literacy, simplifying the healthcare journey and facilitating better healthcare options through value-based partnerships.

SelectRX is a high touch, technology-driven specialized medication management pharmacy. We engage virtually with patients to ensure accurate prescription records are maintained in order to achieve improved prescription drug adherence. SelectRX does this by providing a personalized clinical approach driven by a robust technology platform to track adherence with a world-class pharmaceutical packing and distribution facility.

About the Role:

The Sr. Manager of Pharmacy Revenue Cycle Management will be responsible for leading the billing, collections, posting, and management in excess of $750M pharmacy revenue for +100,000 active members and growing . This position will be focused on improving efficiencies to maximize the revenue and collections within SelectRx. This role is also responsible for defining and executing an accountability structure for the team.

Supervisory Responsibilities:

• This position has direct supervisory responsibilities.

Essential Duties and Responsibilities:

• Strategic Leadership & Financial Performance:
• Develop and implement strategic plans for the end-to-end pharmacy revenue cycle to maximize clean claim submission and net revenue.
• Oversee billing and collections for complex pharmacy claims, including prior authorizations, and complex payer requirements (e.g., Medicare Part D, Medicaid, commercial plans).
• Analyze and report on key performance indicators (KPIs) such as Days in Accounts Receivable (A/R), denial rates, adjustment reasons, and collection percentages, presenting findings and recommendations to senior leadership.
• Manage relationships with external payers and vendors related to billing systems, claims processing, and denial management.
• Develop, manage, and adhere to the department's operating budget.
• Operations & Process Management:
• Lead and continuously improve all revenue cycle operations, including charge capture, claims submission, payment posting, denial management, and appeals.
• Identify root causes of denials and underpayments, leading cross-functional initiatives with Pharmacy Operations, Finance, and IT teams to implement effective solutions.
• Ensure timely and accurate reporting for all financial and operational metrics.
• Drive the evaluation and implementation of new technologies, automation, and AI tools to enhance revenue cycle efficiency
• Compliance & Integrity:
• Assist with internal and external audits related to pharmacy billing and compliance, developing and executing corrective action plans as needed.
• Responsible for auditing PBM payments against contractual rates and reporting on compliance to maximize revenue realization.
• Extensive experience applying and auditing pharmacy billing codes (NCPDP, NDC, HCPCS, CPT, ICD-10, etc.) to ensure compliance and maximize reimbursement across pharmacy benefits
• Team Management & Development:
• Lead, mentor, and empower a team of supervisors and billing specialists.
• Establish clear performance goals, conduct regular performance reviews, and provide specialized coaching to drive team excellence.
• Foster a collaborative, high-performance culture focused on accuracy, compliance, and continuous improvement.
• Collaborate closely with Finance and Accounting on payment application reconciliation and financial reporting.

Skills/Abilities:

• Specialized Knowledge: In-depth, demonstrated knowledge of Pharmacy Revenue Cycle (in-depth expertise in PBM contract auditing, dual medical and pharmacy claims billing, and the complete range of pharmacy codes (NDC, J-codes, CPT) used for revenue integrity.)
• Skills: Exceptional analytical skills with the ability to interpret complex financial data and translate into actionable business strategies.
• Compliance: Strong understanding of current healthcare compliance regulations, including Medicare, Medicaid, and commercial payer requirements.

Education and Experience:

• Bachelor's degree in Accounting, Finance, Healthcare Administration, Business, or relevant experience
• Minimum of 7+ years of progressive experience in Healthcare Revenue Cycle Management, with at least 5 years in a leadership role overseeing large or complex teams required
• Master's Degree (MBA, MHA) or relevant professional certification (e.g., CPA, CHFP, CRCR) preferred
• Experience with pharmacy management & billing platforms preferred

Financial Responsibilities:

• This position has budget responsibility, authority and/or level of control.

Physical Requirements:

• Work is performed indoors with potential for exposure to safety and health hazards related to office work. Could periodically travel to other office and operational sites. The noise level in the work environment is usually moderate.
• Prolonged periods of sitting at a desk and working on a computer.

SelectQuote Core Values:

Service: We create positive customer experiences.

Entrepreneurship: We create innovate & take risks.

Leadership: We build & invest in high-performing teams.

Empowerment: We embrace a changing environment.

Courage: We challenge the status quo & drive continuous improvement.

Teamwork: We help support & celebrate each other.

Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required.

Our Benefits:

The Compensation for this position is listed below. Local minimum wage laws apply. This information is posted pursuant to local requirements to provide applicants with information about what they might be eligible to receive. Individual pay decisions will depend on job-related factors such as experience, education, skill, performance, and geographic location where work will be performed.

Successful candidates may be able to participate in one or more incentive compensation or short-term incentive plans, which could generate additional earnings in accordance with the terms of each plan.

We are proud to offer the following benefits:

• Competitive Medical, Dental, and Vision insurance
• HSA/FSA
• Voluntary Hospital Indemnity, Critical Illness, accident insurance, and short term disability
• Voluntary Life Insurance for self, spouse and dependent
• Company-paid Basic Life Insurance and Long Term Disability
• Retirement plan and employer match contribution with Profit Share
• Tuition Reimbursement program
• Company perks and discount program
• Engaging Wellness and financial education resources
• Employee Assistance Program
• Incentive Plans

Base Salary Minimum

$115,000

Base Salary Maximum

$130,000