Director Reimbursement

2 months ago


Hamtramck, United States Henry Ford Health System Full time

Are you ready to lead the charge in revolutionizing reimbursement practices for one of the nation's top-tier academic and integrated health systems? Henry Ford Health is on the lookout for an exceptional Director of Reimbursement to drive strategic direction in governmental and third-party payer reimbursement programs.

Reporting to the System Vice President of Contracting, Reimbursement & Revenue Integrity, this pivotal role involves overseeing the preparation of third-party cost reports, financial audits, and net revenue forecasts. As a visionary leader, you'll play a key role in implementing cutting-edge reimbursement models and methodologies, fostering innovation, and optimizing automation to ensure industry-leading practices.

If you're a dynamic professional with a proven track record in strategic and operational leadership, don't miss this opportunity to make a lasting impact on healthcare reimbursement. Join us and be at the forefront of shaping the financial future of Henry Ford Health

The Director of Reimbursement is responsible for setting strategic direction for various governmental and third-party payer reimbursement programs. The position will lead evaluation and implementation of best practice reimbursement models and methodologies for the health system. This position will work closely with health system leaders to effectively manage the monthly financial close and net revenue reporting. HFH is seeking a leader with strong strategic and operational skills to drive industry-leading reimbursement practices and processes, including further leveraging automation. These responsibilities include overseeing:

  • Preparation of third party cost reports and other third party filings
  • Reporting and reconciliation of general ledger accounts related to third party payments & settlements, including third party payer receivables, payables and reserves
  • Planning and coordination of third party audits and appeals as well as quarterly and year-end financial audits
  • Preparation of monthly net revenue calculations and review with Vice President prior to financial statement due date
  • Preparation of net revenue forecasts
  • Maintain expertise in reimbursement regulations & strategies, including Medicare, Blue Cross and Medicaid, through appropriate education and provide education and consultation to staff
  • Development of impacts related to changes in reimbursement regulations
  • Provide a leadership role in developing goals and accomplishment of those goals for both team members and the department
Qualifications:
  • Bachelor's degree in Accounting or Finance with a Master's degree preferred
  • Approximately ten (10) years of progressive experience in healthcare reimbursement is required
  • Working knowledge of generally accepted accounting principles and a thorough understanding of third party reimbursement mechanisms
  • Working knowledge of the full Revenue Cycle process and implications on net revenue and accounts receivable valuation
  • Ability to communicate in clear, concise terms
  • Well developed conceptual and analytical skills
  • High level of interpersonal, management and organizational skills


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