DaVita Careers

Manager - Revenue Cycle

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Position Description

Manager - Revenue Cycle <?xml:namespace prefix = "o" ns = "urn:schemas-microsoft-com:office:office" />




This position manages the daily activities of the Pharmacy Revenue Cycle Department; ensuring all aspects and day to day activity is processed in an efficient, timely, accurate manner, and in complete accordance with all applicable laws, regulations, and company policies


Position has full supervisory responsibility for recruitment, hiring, retention, performance development, performance management, salary adjustments, and termination of direct reports.


The shining star in this role should have:

  • Manage Revenue Cycle Department; oversight of assignments, training, and service issue resolution; ensure metrics and service standards are met
  • Manage Revenue Cycle Customer Inbound and Outbound Call teams, maintaining key performance indicators including but not limited to SLA, ACH, ACW, calls holding, teammate adherence and training in support of an optimal customer experience
  • Oversight and knowledge of insurance transactions, specifically adjudication rejections, insurance verification, therapeutic interchanges, credit card processing and prior authorization requests
  • Prior experience with an electronic medical record system. Strong working knowledge of CPT and ICD9/ICD10 codes, HCFA 1500, HIPAA, billing and insurance regulations, medical terminology, insurance benefits and appeal processes
  • Experience managing remote teams in multiple locations
  • Identify, create, monitor, and maintain key performance indicators including but not limited to teammate productivity, quality audits for both queue and calls, and departmental service level agreements
  • Provide consistent, visible, timely, and effective communication to team on team goals and objectives and progress toward those goals
  • Evaluate Revenue Cycle department processes and procedures; suggest and implement methods to minimize labor costs and to improve operations, efficiency, and service to internal and external customers
  • Oversee patient information and records to ensure that all documentation is created and maintained in accordance with HIPAA regulations, and to ensure accurate service is provided.
  • Assist in the development and implementation of Standard Operating Procedures (SOPs) for all insurance department functions
  • Participate in requirements gathering and implementation of new IT applications; ensure appropriate relevance of applications or tools for insurance department purpose and teammates 
  • Extensive knowledge of government regulations and applicable reimbursement laws and regulations required
  • Participate in all daily, weekly and periodic work/management meetings with peers and senior operations leadership
  • Review performance metrics with senior operations and DaVita Rx leadership on an as-needed basis
  • Manage P&L for areas of responsibility
  • Stay current with developing payor coverage and administrative policy changes that could have an impact on payor cash collections; develop appropriate responses and plans to mitigate these risks
  • Maintain absolute compliance with Medicare, Medicaid, and Pharmacy to all applicable regulations via a thorough practice of documentation and organizational skills
  • Assist the Patient Accounts department in resolving claim rejection and denial issues that result from pharmacy billing errors
  • Create and maintain positive relationships with the DaVita Rx Pharmacy operational Directors, Managers and Chief Pharmacists.
  • Provides all necessary documentation required to expedite payments. This includes demographic, authorization/referrals, National Provider Identification (NPI) number, and referring physicians
  • Assist the Patient Accounts department in resolving claim rejection and denial issues that result from pharmacy billing errors
  • Ability to research, review and interpret plan medical policies requirement
  • Other duties and responsibilities as assigned
  • Travel required: up to 30%, varying by month based on business needs

Teammate Management

  • Provide leadership to direct and indirect reports
  • Help direct reports overcome any organizational obstacles encountered
  • Manage all teammate employment activity such as hiring, promoting, job performance, evaluations, and disciplinary actions with appropriate approvals as required
  • Address teammate relations issues appropriately and escalate as necessary
  • Know, understand, implement, follow, and communicate to teammates all DaVita employment policies and procedures, awards, and other opportunities within company; develop and foster a positive, fulfilling work environment; enable teammates to excel in their assigned roles
  • Ensure all DaVita employment processes are completed timely and in compliance with DaVita policy and any applicable laws
  • Facilitate teammate development (PDRs, 1:1 meetings, coaching, mentoring, DaVita training, outside training); collaborate with direct reports to create professional development goals
  • Maintain familiarity with and communicate to teammates DaVita programs impacting teammates (including but not limited to: Triple Crown, We Are Here, Tuition Reimbursement, Foundations, etc.)
  • Provide work direction for department teammates
  • Determine staffing plans that promote the most effective use of all teammates; ensure coverage during teammate absences
  • Propose and provide creative and compliant solutions to daily workflow and temporary labor shortages
  • Know and understand basic wage and hour laws, federal, state and local laws and regulations, Medicare, and legislation affecting employment
  • Review and approve time cards of hourly direct reports for bi-weekly payroll
  • Track overtime, attendance, and PTO
  • Develop and conduct educational programs to keep teammates up-to-date on DaVita policies, new laws and regulations impacting work, and other information necessary to maintain teammates' knowledge of department processes and goals
  • Know, understand, follow, and implement DaVita safety and security policies and procedures
  • Maintain and communicate facility emergency management programs and ability to act swiftly, confidently in an emergency
  • Know, understand, follow, and implement DaVita safety and security policies and procedures


(Education, licenses, certifications, and experience required to fulfill the essential duties, include computer skills as required)

  • Bachelor’s degree in related field recommended; OR equivalent year of experience preferred
  • Experience in insurance claims processing, Medicare Part B and D, State Medicaid Programs, and Prior Authorization rules preferred
  • Must have experience leading an inbound/outbound call center operation and cost center with proven favorable results
  • Minimum of ten (10) years Revenue Cycle supervisory experience preferred
  • Minimum of five (5) years managing call center operation(s)
  • Minimum three (3) year experience in a retail pharmacy or specialty pharmacy setting is highly preferred
  • Intermediate computer skills and proficiency in MS Word, Excel, PowerPoint, and Outlook. 


The DaVita Village Difference<?xml:namespace prefix = "o" />

  • Industry-leading patient care with clinical outcomes ranked above the national average.
  • Dynamic leadership grounded in Core Values, Mission and clearly defined goals for you.
  • Diverse, team-driven culture that supports you.
  • Commitment to developing you and the chance to explore multiple career paths.
  • Stability and strong financial results - 10 years of steady revenue growth.
  • Performance-based compensation and rewards for your hard work.
  • A commitment to the greater good: We are a community first, a company second.


To learn more about DaVita Rx, including a video, please click here.


Go to http://careers.davita.com/ to learn more or apply. 


To learn more about our Village and the world of dialysis, click here.

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DaVita is an equal opportunity/affirmative action employer.  As such, DaVita makes hiring decisions solely on the basis of qualifications and experience, and without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status. 


 We maintain a drug-free workplace and perform pre-employment substance abuse testing and background verification checks.



Position Summary

  • Job Title: Manager - Revenue Cycle
  • Job Function: Other - Corporate Office
  • Location: Coppell, Texas