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Director, Pharmacy RCM Operations

XiFin, Inc.
Charleston, SC Full Time
POSTED ON 9/30/2025
AVAILABLE BEFORE 10/29/2025
Are you interested in harnessing technology and AI to transform healthcare?

At XiFin, we believe a healthier, more efficient healthcare system starts with strong financial and operational foundations. Our innovative technologies help diagnostic providers, laboratories, and healthcare systems manage complexity, drive better outcomes, and stay focused on what matters most: patient care.

We’re on a mission to simplify the business side of healthcare—and we know that mission takes people from all backgrounds and experiences. Whether you’re early in your career or bringing years of expertise, we welcome your perspective, your curiosity, and your passion. We value individuals who ask questions, challenge the status quo, and want to grow while making a real difference.

About The Role

As a Director, Pharmacy RCM Operations at XiFin, you will be part of a high-performing team of specialty professionals reportingdirectly to the Sr. Director, RCM Operations, Pharmacy. In this role, you will be a strategic and operational leader responsible for driving the efficiency, compliance, and financial performance of pharmacy revenue cycle operations—particularly Medicare Part B billing, specialty pharmacy, and infusion services. This role oversees pharmacy billing workflows, ensures compliance with CMS regulations, and leads transformational initiatives to optimize reimbursement and patient access. This is an exciting opportunity to join a team that values continuous learning, mentorship, and operational excellence. This position will be located at our offices in Dallas, TX, or Charleston, SC. US travel is expected for this role, no less than 25%.

How you will make an impact:

In this role, you’ll:

  • Lead the design and continuous improvement of pharmacy billing workflows, focusing on Medicare Part B compliance, reimbursement optimization, and audit readiness
  • Mentor and manage pharmacy managers and billing specialists; oversee training programs to ensure regulatory and system proficiency
  • Build and maintain a pipeline of new business opportunities and identify upsell potential within existing accounts
  • Apply Lean or Six Sigma methodologies to improve billing accuracy, labor efficiency, and turnaround times
  • Partner with finance, compliance, IT, and clinical teams to streamline processes, improve data integrity, and align on payer strategies
  • Develop and monitor performance metrics for billing accuracy, cash collections, denial rates, and reimbursement timelines
  • Evaluate and implement workflow automation tools; leverage EHR and billing systems (e.g., Epic, Cerner, QS/1) for scalable operations
  • Ensure adherence to CMS guidelines, including NCDs, LCDs, DMEPOS billing rules, and audit protocols
  • Stay informed on pharmacy practice trends, PBM policies, 340B compliance, and specialty pharmacy innovations
  • Utilize HL7, FHIR, and ANSI X12 standards to support data exchange and billing accuracy


What you will bring to the team:

We’re looking for someone with a growth mindset and a passion for learning. You might be a great fit if you:

  • Subject matter expertise in infusion drug billing, DMEPOS reimbursement, and Part B audit protocols
  • Exposure to healthcare interoperability technologies and standards (HL7, FHIR, ANSI X12)
  • Ability to drive innovation across pharmacy operations and revenue cycle performance
  • Excellent leadership, communication, and project management skills


Skills and experience you have:

You don’t need to check every box. We will consider a combination of education and experience, including:

  • Bachelor’s degree required; PharmD, MBA, MHA, or related advanced degree preferred
  • 7 years of pharmacy RCM experience, including Medicare Part B, PBM, and specialty pharmacy
  • Strong working knowledge of CMS regulations, payer rules, and billing compliance standards
  • Experience with EHRs and pharmacy billing platforms
  • Proven track record in pharmacy workflow optimization, inventory management, and revenue cycle transformation
  • Familiarity with 340B programs and infusion services
  • Background in Lean, Six Sigma, or process engineering is highly desirable


Why XiFin?

We’re more than just a healthcare technology company—we’re a team that cares about people.

Here’s a glimpse at what we offer:

  • Comprehensive health benefits including medical, dental, vision, and telehealth
  • 401(k) with company match and personalized financial coaching to support your financial future
  • Health Savings Account (HSA) with company contributions
  • Wellness incentives that reward your preventative healthcare activities
  • Tuition assistance to support your education and growth
  • Flexible time off and company-paid holidays
  • Social and fun events to build community at our locations!


Pay Transparency

At XiFin, we believe in pay transparency and fairness. The expected annual salary range for this role is $120,000 to $150,000, based on your experience, skills, and geographic location.

Depending on your qualifications, you may be considered for either a Sr. Manager or Director title. Final compensation will be determined during the selection process and may vary accordingly.

Accessibility & Accommodations

We’re committed to providing an inclusive and accessible experience for all applicants. If you need a reasonable accommodation during the application process, please contact us at 858-436-2901.

Equal Opportunity Employer

XiFin is proud to be an equal opportunity employer. We value diverse voices and do not discriminate on the basis of race, color, religion, national origin, gender, gender identity, sexual orientation, disability, age, veteran status or any other basis protected by law.

Ready to apply?

We’d love to hear from you—even if you’re not sure you meet every qualification. If you're excited about the role and believe you can contribute to our team, please apply. Let's build something meaningful together.

Salary : $120,000 - $150,000

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