AdventHealth University

Director Medicaid Reimbursement

AdventHealth University$146K — $272K *
Healthcare
8 - 10 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree required; Master's preferred in Accounting, Finance, or related field.
  • 10+ years in healthcare finance with a focus on reimbursement and regulatory cost reporting.
  • 5+ years in a leadership role demonstrating management skills.
  • Strong expertise in Medicaid and Medicare reimbursement processes.
  • Proficiency in accounting and financial analysis; CPA certification preferred.

Responsibilities

  • Serve as a Medicaid reimbursement expert for AdventHealth.
  • Lead and mentor a team of reimbursement professionals.
  • Maintain up-to-date knowledge of federal and state Medicaid regulations.
  • Ensure completion of financial entries, audits, and payments.
  • Communicate technical arguments to Medicaid auditors effectively.
  • Identify strategic opportunities for reimbursement optimization.
  • Collaborate with stakeholders to develop and execute reimbursement strategies.

Benefits

  • Professional development opportunities including training and mentoring.
  • Flexible work environment fostering work-life balance.
  • Collaboration with healthcare reimbursement experts.
  • Engagement in continuous learning about healthcare developments.
  • Opportunity to participate in special projects within the organization.
Full Job Description
Schedule:

Full time

Shift:

Day (United States of America)

Address:

900 HOPE WAY

City:

ALTAMONTE SPRINGS

State:

Florida

Postal Code:

32714

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.

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]

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

About AdventHealth University

AdventHealth University is a private university in Orlando, Florida. It was founded in 1992 and is affiliated with the Seventh-day Adventist Church. The university offers undergraduate and graduate degree programs in various fields including nursing, radiography, and sonography. AdventHealth University is accredited by the Southern Association of Colleges and Schools Commission on Colleges.
Learn more about AdventHealth University
Size
1,000 employees
Industry

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