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Director Reimbursement

3 months ago

Edison, United States Hackensack Meridian Health Full time

Overview:

Our team members are the heart of what makes us better.

At Hackensack Meridian Health we help our patients live better, healthier lives and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. Its also about how we support one another and how we show up for our community.

Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.

The Director of Reimbursement & Cost Reporting assumes the leadership role in the direct supervision of the professional staff and serves as a subject matter expert and primary resource person on a broad range of federal and state financial and reimbursement policy issues including IPPS, OPPS, IPF, IRF, etc. for the Hackensack Meridian Health (HMH) Network. Provides effective leadership in the preparation of cost reports; reimbursement compliance and research; reimbursement studies; and other related financial analysis for the Network. By nature of this position, effectively interfaces with various levels of management throughout HMH including but not limited to Operational Executives, Network Management, and Senior Executive Leadership.

Responsibilities:

A day in the life of a Director of Reimbursement & Cost Reporting at Hackensack Meridian Health includes:

  • Improves the overall financial and operational excellence of the Network through the development, deployment and measurement of key policies, processes, tools, technologies and skills as they relate to third party reimbursement.
  • Personnel Management: Responsible for the hiring, supervising, evaluating, and education of all Network Reimbursement professional staff within the department, including two managers.
  • Financial Accounting: Responsible for the central development of the third-party accounts and respective roll forward of activity from the prior period including but not limited to reconciliation of credit balances at the patient level detail. Responsible for the review of third-party calculations maintained on third party general ledger accounts.
  • Leads the direction of the preparation, filing and audit of the systems to construct third party cost reports. Reviews the impact of proposed audit adjustments and develops appropriate responses and negotiates final settlements with third parties.
  • Directs the preparation of the GME IRS filing and DSH filings for the system.
  • Monitors and reports on proposed federal and statutory legislative changes and models impacts accordingly.
  • Develops the 3rd party governmental appeal strategies and initiatives.
  • Leads in the review of subsidies ensuring optimal reimbursement is achieved by keeping a close eye on HMH's safety net providers.
  • Chairs the Wage Index Data Integrity Workgroup to ensure all data elements are reported proper on the Federal Cost Reports.
  • Negotiates with government agencies on behalf of the Network in resolving interim and final payment disputes. Works with internal and external legal counsel and Compliance to resolve disputes in the governmental appeal and legal processes.
  • Participates in various state and national meetings on policy proposals affecting hospitals.
  • Prepares and presents on various reimbursement topics at departmental and interdepartmental meetings as needed.
  • Develops and maintains skilled, customer and team-oriented staff as resources to accomplish duties in a timely, accurate, efficient and positive manner.
  • Creates and sustains an environment that fosters team member engagement. Establishes clear objectives tied to department and/or organizational strategic goals. Coaches, counsels and evaluates performance of direct reports.
  • Uses appropriate application of financial analytical techniques and skills and effective application of broad healthcare business perspective to all engagements by 'going beyond the numbers.'
  • Participates in continuing professional education to keep updated on evolving trends and regulations.
  • Maintains high integrity work papers in a paperless business intelligence work environment.
  • The above statements are intended to describe general nature and level of work being performed. They are not intended to be an exhaustive list of all responsibilities, duties and skills required.
  • Other duties and/or projects as assigned.
  • Adheres to HMH Organizational competencies and standards of behavior.


Qualifications:

Education, Knowledge, Skills and Abilities Required:

  • Bachelor's degree in Accounting/Finance.
  • Minimum of 7 or more years of progressive reimbursement related experience.
  • Demonstrated experience in working in a large health network and/or academic medical center.
  • Advanced proficiency in using technology that includes but is not limited to Microsoft Office (Excel, Outlook, etc.), Axiom and PeopleSoft Financials System.
  • Strong interpersonal, team and organizational skills.
  • Proven record of progressive professional growth and responsibility.
  • Strong analytical and problem solving skills.
  • Excellent written and verbal communication skills.

Licenses and Certifications Preferred:

  • Certified Public Accountant (CPA) and/or Masters of Business Administration (MBA).

If you feel that the above description speaks directly to your strengths and capabilities, then please apply today