Senior Manager, Revenue Cycle Management – Home Infusion
New
S
Shields Health SolutionsHome Infusion
RemoteFull-TimeManager
Salary not disclosed
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Job Details
- Experience
- 5+ years of progressive revenue cycle experience
- Required Skills
- Process improvement
Requirements
- Bachelor’s degree required; MBA preferred.
- 5+ years of progressive revenue cycle experience in home infusion, specialty pharmacy, or closely related healthcare setting.
- 2+ years of leadership or team management experience preferred.
- Strong financial acumen connecting revenue cycle performance to cash flow, margin, forecasting, and working capital.
- Deep understanding of home infusion reimbursement, including both pharmacy and medical benefit billing.
- Proven experience with billing/reimbursement across commercial, Medicare, Medicaid, and managed care payors.
- Knowledge of prior authorization, benefits investigation, claim adjudication, and payor appeals processes.
- Demonstrated experience improving AR performance, denial resolution, and cash collections.
- Executive presence with the ability to communicate with C-suite and senior operational leaders.
- Experience with infusion billing platforms, pharmacy systems, and reporting/analytics tools.
Responsibilities
- Develop and execute revenue cycle strategy, aligning operational performance with cash acceleration and margin protection goals.
- Manage core RCM functions including billing, follow-up, denial management, collections, cash posting, and AR resolution.
- Partner with intake, clinical, and authorization teams to ensure accurate patient onboarding, coverage verification, and prior authorization.
- Oversee reimbursement workflows for both pharmacy and medical benefit claims, including infusion drugs, nursing, and supplies.
- Monitor key performance indicators like DSO, clean claim rates, and denial rates to identify trends and action plans.
- Lead revenue cycle transformation initiatives including workflow redesign, automation, and system optimization.
- Supervise, coach, and develop RCM staff, establishing productivity standards and accountability.
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