Full Job Description
* Serves as AdventHealth subject matter resource for Medicaid reimbursement matters. This role is focused on Medicaid payment areas. * Leads a team of reimbursement professionals, providing guidance, training, and development opportunities. * Maintain a strong working knowledge of current laws and regulations of the federal and state Medicaid programs * Ensures data, payments, settlements, audits, and financial entries are completed. * Communicate technical positions/arguments effectively to Medicaid auditors to support positions. * Leverages reimbursement expertise to identify strategic opportunities supporting long-term reimbursement optimization and sustainability. * Propose year end estimated Medicaid third party financial settlement to be audited by AdventHealth's external auditor for inclusion in the audited financial statements. * Proactively seeks to improve strategy and reduce risks. This includes managing outside consultants and engaging with hospital associations. * Creates solutions in compliance with regulations * Collaborates with key stakeholders to support the reimbursement initiative and to identify, plan and execute reimbursement strategy. * Collaborates with other large system reimbursement leadership to identify best practices and incorporate learnings within the organization. * Engages in continuous knowledge development regarding healthcare industry developments, best practices, tools and techniques. * Responsible for ensuring that the potential of future take backs, is understood, communicated, and managed appropriately. * Educates Finance, Revenue, Cycle & Operational Leaders on regulations & impacts * Communicate with key stakeholders on opportunities and impact, both regarding current issues as well as fundamentals of reimbursement for those in new roles * Strategic Thinking deployed identifying new reimbursement mechanisms, ensuring the proper development, management and optimization of existing programs (coordinate, grow, reduce risk) and identify when and whether to join appeal cases. * Consults with leadership, providing guidance how to ensure stability of existing programs and strategic options to consider, to fulfill our mission * Provides mentoring and coaching to staff, develops future financial leaders, recruits top-tier talent * Utilizes excellent communication skills, including adjusting or adapting messaging for different stakeholders. * Participates in and/or lead special projects as assigned.
Knowledge, Skills, and Abilities:
• N/A
Education:
• Bachelor's [Required]• Master's [Preferred]
Field of Study:
• in Accounting, Finance, or related field
Work Experience:
• 10+ years of relevant experience in healthcare finance, preferably in reimbursement including medicare, medicaid reimbursement and regulatory cost reporting [Required]• 5+ years of proven leadership skills in management role [Preferred]• Strong background in accounting and financial analysis [Required]
Additional Information:
• N/A
Licenses and Certifications:
• Certified Public Accountant (CPA) [Preferred]
Physical Requirements: (Please click the link below to view work requirements)
Physical Requirements - https://tinyurl.com/23km2677
Pay Range:
$146,405.57 - $272,307.13