Pharmacy Revenue Cycle Manager

Job Description Summary The Pharmacy Revenue Cycle Manager leads pharmacy revenue cycle and revenue integrity activities across the health system. This position promotes accurate medication charge capture, billing, reimbursement, reconciliation, and financial reporting. The manager partners with Pharmacy, Revenue Cycle, Finance, Information Solutions, Compliance, Managed Care, and operational leaders to reduce revenue leakage, resolve billing issues, improve reimbursement, and maintain regulatory and payer compliance. Entity Medical University Hospital Authority (MUHA) Worker Type Employee Worker Sub-Type Regular Cost Center CC004415 SYS - ICCE - Pharmacy Pay Rate Type Salary Pay Grade Health-36 Scheduled Weekly Hours 40 Work Shift Position Summary The Pharmacy Revenue Cycle Manager leads pharmacy revenue cycle and revenue integrity activities across the health system. This position promotes accurate medication charge capture, billing, reimbursement, reconciliation, and financial reporting. The manager partners with Pharmacy, Revenue Cycle, Finance, Information Solutions, Compliance, Managed Care, and operational leaders to reduce revenue leakage, resolve billing issues, improve reimbursement, and maintain regulatory and payer compliance. Key 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. Minimum Qualifications Degree in Pharmacy, Finance, Accounting, Business Administration, Healthcare Administration, Health Information Management, 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. Preferred Qualifications PharmD, MBA, MHA, Master of Finance, or another relevant advanced degree. Active pharmacist licensure when required by the position’s scope. Experience in an academic medical center, integrated health system, or complex multi‑site pharmacy enterprise. Knowledge of hospital and professional billing, HCPCS coding, National Drug Codes, revenue codes, payer policies, and medication reimbursement. Experience with Epic, Willow, Workday, Power BI, Tableau, or comparable systems. Knowledge of specialty pharmacy, infusion billing, high-cost medications, patient assistance, medication management, and 340B operations. Relevant certification in revenue cycle, coding, compliance, or project management. Strong knowledge of pharmacy reimbursement and healthcare revenue cycle operations. Effective financial analysis, problem‑solving, and process‑improvement skills. Ability to translate payer and regulatory requirements into operational workflows. Strong leadership, communication, presentation, and relationship‑management skills. Demonstrated attention to detail, sound judgment, and commitment to billing accuracy, compliance, and data integrity. Ability to manage multiple priorities and collaborate across clinical, operational, financial, technical, and compliance teams. Education Bachelor's degree or equivalent education and/or relevant work experience Work Experience 9 years progressive work experience and 4 years management experience If you like working with energetic enthusiastic individuals, you will enjoy your career with us! The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need. Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: Thank you for wanting to be part of the Medical University of South Carolina team. Whether you want to teach the next generation of health care leaders, innovate new business models, discover the next breakthrough or provide patient care, there's a role for you that fuels your passion and takes advantage of your skills. There are career opportunities available in academics, research, hospital medicine, physician practices and support services, from patient billing to IT. MUSC attracts more than $250 million annually in research funding, making it the biggest magnet for biomedical, extramural research dollars of all institutions of higher learning in South Carolina. The Clinical and Translational Science Award (CTSA) Program aims to advance clinical and translational science to increase the speed at which new treatments become available to patients. MUSC Health, the clinical enterprise, operates a 750 bed medical center, which includes a nationally recognized Children’s Hospital, the Ashley River Tower (cardiovascular, digestive disease, and surgical oncology), Hollings Cancer Center (one of fewer than 70 elite National Cancer Institute designated centers), a Level I Trauma Center and the Institute of Psychiatry. In addition, there are more than 100 outreach clinics, hospital/health system affiliations, and telehealth sites. U.S. News & World Report placed us among the top one percent of all American hospitals, with 11 specialties in the top 50. The MUSC Medical Center is also one of only three Magnet designated hospitals in South Carolina. #J-18808-Ljbffr