Senior Manager, Revenue Cycle Management – Home Infusion

Senior Manager, Revenue Cycle Management – Home Infusion

The Senior Manager Revenue Cycle Management – Home Infusion serves as a strategic revenue cycle leader responsible for driving financial performance, operational scalability, and reimbursement excellence across the home infusion platform. This role partners with health system executives, internal leadership teams, finance, pharmacy operations, payer contracting, compliance, and client leadership to optimize cash flow, reduce revenue leakage, improve margin realization, and support growth. The ideal candidate combines deep home infusion reimbursement expertise with executive presence, strong financial acumen, data-driven decision-making, and the ability to lead cross-functional transformation in a complex, high-growth healthcare environment.

Key Responsibilities

• Serve as a senior revenue cycle leader and trusted advisor to health system executives, internal leadership team members, finance leaders, pharmacy leadership, and operational stakeholders on home infusion reimbursement performance, risks, and strategic opportunities.
• Develop and execute the revenue cycle strategy for home infusion services, aligning operational performance, payer reimbursement requirements, cash acceleration, margin protection, and scalable growth objective
• Build and maintain strong relationships with health system executives and senior operators to ensure alignment on revenue cycle expectations, performance commitments, issue resolution, and long-term partnership goals.
• Lead revenue cycle transformation initiatives across home infusion, including workflow redesign, automation, analytics, standardization, system optimization, and operating model improvements.
• Manage core home infusion RCM functions, including billing, follow-up, denial management, collections, cash posting, and AR resolution.
• Oversee reimbursement workflows for both pharmacy and medical benefit claims, including coordination of infusion drug, nursing, supplies, and ancillary service billing as applicable.
• Monitor and improve key performance indicators such as DSO, aging, clean claim rate, first-pass yield, denial rate, cash collections, write-offs, and authorization-related reimbursement leakage.
• Lead payor-specific billing and follow-up strategies for commercial, Medicare, Medicaid, managed Medicaid, and other government and contracted payors.
• Partner with intake, clinical, and authorization teams to ensure accurate patient onboarding, coverage verification, prior authorization, and financial clearance processes.
• Ensure timely identification, escalation, and resolution of billing edits, denials, underpayments, and documentation deficiencies.
• Review AR trends and develop action plans to accelerate collections and reduce preventable denials.
• Collaborate with client finance teams on cash forecasting, month-end close support, bad debt analysis, and reserve considerations related to revenue cycle performance.
• Maintain strong knowledge of home infusion reimbursement rules, including payer policy requirements, Medicare and Medicaid billing considerations, and site-of-care reimbursement dynamics.
• Support implementation and optimization of billing systems, workflow automation, reporting tools, and process controls.
• Supervise, coach, and develop RCM staff; establish productivity standards and accountability mechanisms across the team.
• Serve as a cross-functional partner to contracting, operations, and compliance on reimbursement issues, audit responses, and process redesign initiatives.

Qualifications

• Bachelor’s degree required, MBA preferred
• 5+ years of progressive revenue cycle experience in home infusion, specialty pharmacy, infusion services, or a closely related healthcare setting.