Director of Reimbursement, Specialty Pharmacy 24-00237 - Alura Workforce Solutions

Position
Director, Reimbursement 
(Specialty Pharmacy) 

Position Overview: 
As the Director of Reimbursement, you will play a pivotal role in overseeing the Billing, Authorizations, and Collections departments within our Specialty Home Infusion Pharmacy. You will be responsible for optimizing revenue collection, ensuring compliance with billing and reimbursement guidelines, and implementing effective processes to support our mission of providing exceptional patient care.

Key Responsibilities:

1. Departmental Leadership:
   Lead, mentor, and manage the Billing, Authorizations, and Collections departments, fostering a culture of excellence, accountability, and teamwork.
2. Revenue Optimization:
   Develop and implement strategies to maximize revenue collection and minimize revenue leakage, including the oversight of claim submissions, payment processing, and denial management.
3. Compliance:
   Ensure compliance with all federal and state regulations, payer guidelines, and industry standards related to billing, authorizations, and collections.
4. Process Improvement:
   Identify opportunities for process improvements within the reimbursement cycle and drive initiatives to enhance departmental efficiency and accuracy.
5. Payer Relations:
   Build and maintain strong relationships with payers, including negotiation of contracts, understanding reimbursement policies, and staying informed about changes in the healthcare reimbursement landscape.
6. Staff Development:
   Recruit, train, and develop departmental staff, providing ongoing coaching and support to enhance their skills and knowledge.
7. Reporting and Analytics:
   Oversee the generation of financial and operational reports to monitor key performance indicators and make data-driven decisions. 8. Collaboration: Collaborate with cross-functional teams, including pharmacy operations, clinical services, and finance, to ensure effective communication and alignment of goals.
8. Collaboration:
   Collaborate with cross-functional teams, including pharmacy operations, clinical services, and finance, to ensure effective communication and alignment of goals.

Qualifications: 

• Bachelor's degree in healthcare administration, Business, or related field (Master's degree preferred).
• Minimum of 10 plus years of progressive leadership experience in healthcare reimbursement, with a strong background in billing,authorizations, and collections.
• In-depth knowledge of healthcare billing systems, reimbursement regulations, and payer policies.
• Proven track record of successfully leading and developing high-performing teams.
• Exceptional analytical, problem-solving, and decision-making skills.
• Strong interpersonal and communication abilities, with the capacity to build relationships with both internal and external stakeholders.
• Detail-oriented and well-organized, with the ability to manage multiple priorities in a fast-paced environment.
• Proficiency in healthcare billing software and financial reporting tools.

Additional Information: 
On-Site Position
Full-Time, Direct Placement, Benefited 

INDH