Job DescriptionWe are seeking a highly energetic individual who has a "can do" attitude to join our exciting outpatient healthcare company as a seasoned
Director of Managed Care Reimbursement. This position will be housed on the Managed Care team and reports to the Vice President of Managed Care Operations. The primary objective for this role is to develop strategic initiatives to grow the company's revenue stream.
QualificationsKNOWLEDGE AND SKILLS:- Minimum of five years (5) experience in: Finance, Medical Economics or Revenue Cycle
- Versed in modeling and analytics
- Skilled in synthesizing data
- High proficiency maneuvering private, federal & state fee schedules as well as supporting guidelines in a nationwide setting for all payor mix types.
- Provide VP with strategic analysis and trend evaluation
- Translate reimbursement changes & the impact to revenue stream
- Communicate policy changes cross-functionally
- Familiar with various reimbursement models and methodologies including but limited to: Daily Max, Fee for Service, RBRVS, Medicaid, value-based payment models, escalators, bundled payments & shared savings.
- Drive initiatives to identify and recoup underpayments
- Oversee the Payment Compliance & Chargemaster teams
- Support VP in due diligence for strategic partnerships
EDUCATION & EXPERIENCE: - Bachelor's/Masters in Business, Finance, Health Care or related field required
- EMR experience, Raintree experience a plus
- Experience with BI tools
- Advanced Microsoft experience in: Excel, Pivot Tables, Vlookup, etc.
- Effective project management skills
- Strong critical and analytical skills, ability to work strategically
- Excellent oral and written communication skills
- Proven strong organization, interpersonal and management skills. 5+ years' experience in health care setting
Additional InformationThe anticipated base salary range for this position is 135,000-145,000. Salary is based on various factors, including relevant experience, knowledge, skills, other job-related qualifications, and geography. Medical, dental, vision, 401(k), paid time off, and other benefits are also available, subject to the terms of the Company's plan.
