The principal goal of the Corporation’s Reimbursement Team shall be timely execution of data gathering, preparation, review, and issuance of required third-party cost reports, with excellence and reliability.  Further, the Team shall have the goal of providing relevant financial, reimbursement, and operational data for optimal decision making.  Finally, the Reimbursement Team shall consistently add value to the Corporation through its efforts to enhance net revenue.

Duties include:

1.  Manage all aspects of annual and interim cost reporting process, in conjunction and in consultation with Director.  This shall include establishing calendar/project plans, coordinating analyst staff assignments, ongoing collaboration with external consultants, review of workpapers, review of drafts, and other similar duties required to complete cost reports on time and with highest level of accuracy and completeness.
2. Coordinate review and analysis of interim rate reviews, tentative settlements, desk review/pending settlement letters, NPRs, etc – within noted timeframes and deadlines to respond.  This shall include assignment of duties, high focus on audit adjustments, review of workpapers, and other similar duties.
3. Seek to develop effective relationships with governmental auditors, such that the desk review and settlement process is augmented.
4. Perform or supervise the completion of financial, cost, operational, and reimbursement proforma analyses to support the Project Planning Process.
5. Supervise or complete other special reimbursement projects at the behest of the Director, CFO, or other senior leaders of the Corporation.
6. Maintain and grow competency of reimbursement and health care finance knowledge through various means.  Effectively convey sophisticated reimbursement information to decision makers within the Corporation.  Provide educational presentations to various groups as needed.
7. Oversee managed care contract review process, as well as analysis of new or amended payer contract proposals.
8. Provide effective leadership, supervision, and oversight to a team of highly-performing analysts.
9. Create/generate/facilitate reports from internal decision support system as needed and directed to provide clinical, operational, financial or other data for leaders and decision makers through the organization. 
10. Assist CFO, Director of Finance, or other leaders in financial analysis and designated projects.  Provide leadership by contributing in a collaborative team of finance professionals.

Education

 This candidate must have a Bachelor's degree in finance, accounting or business administration, or any comparable level of education, and experience preferably in a hospital setting.   Master’s degree or relevant certification [e.g. CPA] is a plus. 

Minimum Work

Experience

The successful candidate should have a minimum of 5 to 10 years of relevant experience in a healthcare finance setting, and should also have demonstrated expertise and knowledge in Medicare and Medicaid reimbursement regulations, including DSH, IME/GME, CAH, wage index and related topics.  Excellent computer skills [MS Excel/Office], and communication skills are a must. desirable.

Required Licenses/Certifications

 None

Required Skills, Knowledge, and Abilities

·         Solid working knowledge of Medicare and Medicaid Regulations

·         Experience in preparation, review, and appeal of third-party cost reports

·         Knowledge of MAC/MCO/Agency operations; diplomatic skills and effective communications with auditors

·         Strong analytical and quantitative skills

·         Expertise in Excel and related computer applications

·         Excellent critical thinking skills.

·         Ability to multitask and prioritize assignments while producing high quality work in a demanding, fast-paced environment

·         Excellent verbal and written communication, teamwork, and relationship-building skills.

·         Effective presentation skills, along with comfort level in conversing and interacting with Corporate leadership

·         Excellent skills in managing workload timely and efficiently

·         Demonstrated leadership and ability to lead, supervise, and produce excellent results from team