Director, Pharmacy Revenue Cycle Management

Become a part of our caring community and help us put health first
 

The Director, Revenue Cycle Management for Humana Pharmacy will own the billing, collections and reporting for CenterWell Pharmacy & Specialty pharmacy and Humana Pharmacy Solutions, Humana’s captive PBM. 

This role will lead a large workforce across multiple geographies to maximize our billing while also ensuring to meet our patient, pharmaceutical clients and PBM partner needs.  Within CenterWell Pharmacy, we continue to lead the industry with new product launches, including our Direct to Consumer and Direct to Employer offerings. This leader will be nimble and change oriented to meet the evolving market needs.  This position may involve some financial budgeting as well as making decisions related to implementation of new/updated programs or large-scale projects to help support the strategic goals of the pharmacies. Additionally, the candidate will have the following key responsibilities:

·       Own the reconciliation of billing with the GL with partnership with controllership team

·       Provide comprehensive decision-making across the enterprise as it comes to revenue accounting

·       Develop and maintain team performance across our BPO partner and internal associates

·       Monitor performance by comparing and analyzing actual results with plans and forecasts

·       Improve financial status by analyzing results and variances, identifying trends, and recommending actions

Use your skills to make an impact
 

Required Qualifications

• Bachelor's degree in finance, accounting or related field
• 8 or more years of revenue cycle management
• 5 or more years of management experience
• Experience advising senior leadership on billing/collections strategies
• Knowledge of pharmacy revenue cycle management
• Prior experience developing methods and criteria for revenue cycle management
• Exceptional communication and presentation skills, with the ability to influence and engage diverse audiences
• Ability to lead and manage special projects that may necessitate cross-functional partnerships
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

• Prior health insurance industry experience working in revenue cycle management
• Pharmacy pricing knowledge or experience

Additional Information

Interview Format
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

WAH Internet Statement
To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
 

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$126,300 - $173,700 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Us
 

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

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Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.