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Senior Manager, Reimbursement - Specialty Pharmacy

Company Name: Kroger Specialty Pharmacy
Position Type: Employee
FLSA Status: N/A



Position Summary

Oversee all revenue cycle management (RCM) functions for all Kroger Specialty and Infusion pharmacies (KSP). Focus on successfully meeting RCM goals including revenue collection, reduction in DSO and bad debt, and continual attention to talent development. Make decisions for which there is little precedent. Demonstrate the company's core values of respect, honesty, integrity, diversity, inclusion, and safety.

Essential Job Functions

  • Manage RCM functions across all KSP business units; responsible for teams located in multiple regions across the U.S.
  • Develop and implement plan to coordinate RCM functions under one leadership; establish comprehensive policies, procedures and work instructions providing a common reference for all teams
  • Oversee from a business owner perspective RCM functions, systems, and procedures; drive organization productivity gains via process re-engineering, best practices, and continuous improvement
  • Partner with Finance and Accounting to ensure seamless financial close of source systems; work with Operations and Compliance to improve processes and minimize AR risk
  • Drive key performance metrics, including timely and accurate billing, collections, reduction in total AR balances and reduction in DSO and bad debt
  • Ensure RCM activities are performed within policies, work instructions and in accordance with legal and regulatory requirements; annually assess for legal and regulatory efficacy
  • Lead recruiting and talent development for RCM; provide direction on training and orientation into work environment, communication of expectations, and ongoing coaching
  • Communicate performance results regularly to associates and leaders facilitating root cause analysis and problem-solving process to identify permanent solutions to underperforming factors
  • Maintain knowledge of industry trends, commercial and government guidelines, and billing and RCM requirements; deploy resources in anticipation of regulatory or payer changes
  • Perform and assist with operations to maintain workflow and to meet schedules and quality requirements; provide feedback to operations on trends impacting AR
  • Participate in a variety of meetings and work groups to integrate activities, communicate issues, obtain approvals, resolve problems and maintain specified level of knowledge pertaining to new developments, requirements, and policies
  • Supervise and coach direct reports in the performance of their duties; complete performance reviews and provide feedback to direct reports
  • Perform other related duties as assigned
  • Must be able to perform the essential job functions of this position with or without reasonable accommodation
  • Minimum Position Qualifications

  • High School Diploma or GED
  • 7+ years of experience within healthcare industry
  • 6+ years of experience in leadership
  • 3+ years of receivable management experience
  • Skilled collaborator with the ability to work across disciplines to positively impact organization results
  • Expert in root cause analysis; ability to solve complex situations while guiding teams
  • Strong knowledge of business and ability to analyze data to identify gaps and actions to be taken
  • Strong skills in coaching, continuous learning, fostering a positive culture, training for depth of understanding and improving organization performance by improving individual results
  • Deep technical knowledge of medical billing and collections across a range of payor types including commercial, government, pharmacy, and major medical claims
  • Highly effective communicator demonstrating positive listening; clear written and oral communication
  • Desired Previous Experience/Education

  • Bachelor's Degree in business, accounting, or similar field

    Education Level: High School Diploma/ GED Required
    Required Certifications/Licenses: None
    Position Type: Full-Time 
    Shift(s): [[mfield4]]

    Regions: Any


    Jobs at Kroger: At Kroger, we hire people who have a passion for helping others and who want to build a relationship with our Customers. No matter what stage of your career, you can build your future at Kroger. We look for people who want more, aspire to be more and work hard to achieve their goals. Our focus on keeping the Customer first is what makes us successful. We offer many opportunities not only in our stores, but in Manufacturing, Logistics, Marketing, Finance, Human Resources, and many other fields.

    Company Overview: Kroger Family of Companies employs nearly half a million associates who serve over 11 million customers daily through a seamless shopping experience under a variety of banner names.  At The Kroger Co., we are Fresh for Everyone™ and dedicated to our Purpose: To Feed the Human Spirit®.  We are committed to creating #ZeroHungerZeroWaste communities by 2025.  Careers with The Kroger Co. and our family of companies offer competitive wages, flexible schedules, benefits and room for advancement.


     Posting Notes:  FL || Lake Mary || 3200 Lake Emma Drive || 32746 || Kroger Specialty Pharmacy || None || Reimbursement; Specialty Infusion; Specialty Pharmacy || Employee || Exempt || Full-Time || None 

    Nearest Major Market: Orlando

    Job Segment: Accounts Payable, Pharmacy, Medical, Engineer, Law, Finance, Healthcare, Engineering, Legal

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