Manager, Pharmacy Reimbursement

Beth Israel Lahey Health • Westwood, MA

4d • $95,000 - $130,000

About The Position

The Manager, Pharmacy Reimbursement leads reimbursement and related analytics operations for a pharmacy enterprise generating approximately $300 million in annual revenue. Reporting to the Director of Pharmacy Finance, the role is responsible for optimizing reimbursement, revenue integrity, manufacturer rebate programs, Medicare Maximum Fair Price (MFP) initiatives, and accounts receivable performance while ensuring regulatory compliance and supporting strategic growth across the pharmacy enterprise.

Requirements

• Bachelor's degree in Finance, Accounting, Healthcare Administration, Business Administration, Pharmacy, or a related field.
• Minimum seven years of progressive experience in pharmacy finance, healthcare finance, reimbursement, revenue cycle, revenue integrity, or related disciplines.
• Minimum three years of leadership or management experience.
• Demonstrated experience developing financial analyses and executive-level reporting.
• Knowledge of pharmacy reimbursement, revenue cycle management, manufacturer rebates, Medicare Part B and Part D reimbursement, and MFP methodologies.
• Strong analytical, financial modeling, and problem-solving skills.
• Advanced Excel, reporting, and business intelligence capabilities.
• Strong leadership, communication, project management, and stakeholder management skills.
• Ability to lead cross-functional initiatives and drive measurable financial results.
• Staff must be vaccinated against influenza as a condition of employment.

Nice To Haves

• MBA, MHA, MS Finance, PharmD, or other relevant advanced degree.
• Experience leading pharmacy revenue cycle functions within large health systems or pharmacy enterprises, contract pharmacy programs, and manufacturer rebate programs.
• Experience with Epic Willow, Beacon, and enterprise financial reporting tools.

Responsibilities

• Lead pharmacy revenue cycle operations, including billing, charge capture, reimbursement, denials management, and accounts receivable performance.
• Develop and implement strategies to optimize revenue, improve collections, reduce revenue leakage, and enhance cash flow.
• Oversee manufacturer rebate programs and Medicare Maximum Fair Price (MFP) financial processes to maximize reimbursement and financial performance.
• Partner with Pharmacy Operations, Finance, Revenue Cycle, 340B, Compliance, and Informatics teams to support operational and growth initiatives.
• Monitor revenue integrity, reimbursement trends, and key performance indicators, providing actionable insights and recommendations.
• Develop executive-level financial reports, dashboards, forecasts, and analyses to support decision-making and strategic planning.
• Recruit, develop, and lead revenue cycle staff while fostering a culture of accountability, service excellence, and continuous improvement.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager