Senior Manager Reimbursement

2 weeks ago

Baltimore, United States The University of Maryland Medical System Full time

The University of Maryland Medical System is a 14-hospital system with academic, community and specialty medical services reaching every part of Maryland and beyond. UMMS is a national and regional referral center for trauma, cancer care, Neurocare, cardiac care, women’s and children’s health and physical rehabilitation. UMMS is the fourth largest private employer in the Baltimore metropolitan area and one of the top 20 employers in the state of Maryland. No organization will give you the clinical variety, the support, or the opportunities for professional growth that you’ll enjoy as a member of our team. Job Description

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified. 1. Manages and directs the operations of the Reimbursement and Revenue Advisory Services department including employee work scheduling, staffing and other personnel activities; applies UMMS policies and procedures as well as federal, state (HSCRC), and local statues or regulations governing reimbursement to insure accurate and effective service. A. Ensures that UMMS policies and procedures are interpreted and applied correctly. Develops and implements reimbursement policies and procedures as necessary to improve department operations. Provides technical leadership regarding the implementation of HSCRC reimbursement methodologies and revenue reporting requirements to the VP, Directors, and Senior Managers of Finance Shared Services, to CFOs of member hospitals and to other members of Senior Management. B. Interprets new HSCRC policy and standardizes process implementation throughout UMMS financial reporting. Uses technical expertise to model new policy, calculate impact, and implement change. C. Supervises the preparation of the monthly financial statement revenue in accordance with UMMS procedures and HSCRC defined methodologies. Reviews monthly HSCRC volume and revenue submissions; communicates with the HSCRC as necessary. D. Ensures the accurate and timely preparation of various HSCRC, Medicare and other regulatory reports on a monthly, quarterly and annual basis. Manages the staff during the Annual Filing and Medicare Cost Report preparation processes. E. Coordinates the annual budget process for multiple facilities ensuring that intermediate and final deadlines are met. Evaluates key financial implications of projected changes in compliance methodologies and hospital based initiatives.

F. Participates in the development and implementation of goals, policies, and fiscal plans for the department 2. Manages the reporting and monitoring of key Reimbursement functions which includes: A. Development, implementation and monitoring of reimbursement strategies to maximize revenue and monitor price position in marketplace. Oversee, implement, and verify rate changes to get into HSCRC compliance. B. Management of monthly rate analytics and the adjustment of rates to ensure compliance with federal, state (HSCRC) and local laws and regulations and oversees the preparation of the annual approved rate calculation and rate reviews for various UMMS hospitals. C. Responsible for the detailed preparation of the HSCRC Annual Filing and other regulatory disclosures, assisting with the detailed preparation of the annual Medicare Cost Report and completion of the annual Revenue Budget. D. Communicates relevant regulatory changes and/or protocol and procedural revisions to senior management and staff. Implements appropriate departmental operational changes to ensure compliance.

3. Manages and directs a staff of Senior and Reimbursement Analysts in accordance with departmental and UMMS personnel policies and procedures. A. Performs individual performance evaluations and recommends and/or initiates corrective actions, as needed. Establishes clear and concise work procedures and expectations, assessing performance levels by monitoring results and providing positive and constructive feedback. B. Promotes and encourages professional growth and development of personnel through attendance at in-services, workshops and seminars. Trains staff on new practices and promotes staff professional development C. Ensures timely and accurate completion of work by monitoring daily work activities. D. Trains staff on new accounting practices, provides guidance on technical and reporting issues and otherwise promotes staff professional development. 4. Acts as the main point of contact for decision support, financial reporting and other finance personnel to ensure optimal efficiency and effectiveness of financial reporting. 5. Keeps abreast of current regulatory (federal, state, HSCRC and JCAHO) information/guidelines and new, related hospital policies; communicates relevant changes and/or protocol and procedural revisions to staff. Implements appropriate department operational changes to ensure compliance. 6. Acts as a liaison between RRAS, HSCRC, MHA, MHCC, and hospital executive leadership. 7. Actively participates in regulatory industry workgroups and meetings, acting as the UMMS representative to influence decisions regarding policy changes or additions. 8. Attends and participates in in-service training and various educational programs for professional growth and development. 9. Keeps up-to-date on changes in the hospital finance and reimbursement field.

Qualifications

1. Knowledge of state and federal reimbursement laws and regulations is required. Demonstrated expertise of HSCRC reimbursement methodologies is required. Proficiency in preparing and analyzing financial data and implementing changes to contain costs for budgetary purposes. 2. Proficient knowledge of supervising, monitoring daily work activities, evaluating, training and motivating performance of subordinate technical, professional and clerical support staff. 3. Proficient organization and problem-solving skills are required to develop/implement efficient work processes and to successfully resolve difficult, conflict-oriented situations. Ability to work effectively in a stressful work environment. Ability to handle confidential issues with integrity and discretion. 4. Highly effective verbal and written communication skills are necessary. 5. Highly proficient mathematical & computer skills are required. 6. Technical expertise in MS Excel, MS Word, and PowerPoint. 7. Design and implement models and templates that can be used by staff to assure standardized process implementation on new initiatives.

Additional Information

All your information will be kept confidential according to EEO guidelines.

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