Program Manager - Reimbursement - Special Projects

11 - 15 years experience  • 

Salary depends on experience
Posted on 02/23/18
King Of Prussia, PA
11 - 15 years experience
Salary depends on experience
Posted on 02/23/18

Job Description

One of the nation’s largest and most respected hospital companies, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Steadily growing from a startup to an esteemed Fortune 500 corporation, UHS today has annual revenue nearing $10 billion. In 2017, UHS was recognized as one of the World’s Most Admired Companies by Fortune; ranked #276 on the Fortune 500, and listed #275 in Forbes inaugural ranking of America’s Top 500 Public Companies.

Our operating philosophy is as effective today as it was 40 years ago: Build or acquire high quality hospitals in rapidly growing markets, invest in the people and equipment needed to allow each facility to thrive, and become the leading healthcare provider in each community we serve.

Headquartered in King of Prussia, PA, UHS has more than 81,000 employees and through its subsidiaries operates more than 320 acute care hospitals, behavioral health facilities and ambulatory centers in the United States, Puerto Rico, the U.S. Virgin Islands and the United Kingdom.

This position completes Medicare Disproportionate Share Hospital (DSH) Packages (and Medicare SSI Determinations) to support Acute Care Division annual cost report submissions and related audit activity.  In addition, it oversees the completion of Medicare S-10 Uncompensated Care worksheets and handles all related audit activity. 

Essential Job Duties

  • Completes Medicare DSH packages for all acute care division hospitals and handles all related audit activity in coordination with the hospital’s designated Reimbursement Manager
  • Handles all Medicare DSH SSI ratio Cost ReportYear End versus Federal Fiscal Year determinations and related activity
  • Oversees the completion of the Medicare cost report S-10 worksheet data elements using external software and handles related Medicare and/or Medicaid audit activity
  • Provides recommendation for changes in hospital charity and otherfinancial assistance policy(s) (FAP’s) to ensure compliance with the applicable federal and/or state rules and regulations and optimization of related reimbursement
  • Working with the VP-Reimbursement, monitors and provides analysis of Medicare and Medicaid legislative, regulatory and administrative rule activity
  • Handles Reimbursement special projects assigned by VP-Reimbursement, as applicable

Requirements

Bachelor's degreerequired with 10+ years' experience

  • Expert knowledge of Medicare Disproportionate Share Hospital (DSH) rules and regulations
  • Expert knowledge of Medicare S-10 Uncompensated Care (UC) rules and regulations
  • Expert knowledge of Medicare statutes, regulations and administrative rules and their related legislative and regulatory processes
  • Expert knowledge of Medicare prospective payment systems including Inpatient Acute DRGs (IPPS), Outpatient APCs (OPPS), Rehabilitation CMGs (IRF PPS) and Psychiatric PPS (IPF PPS)
  • Understanding of Medicaid supplemental payments (UPL), Health-care Related Taxes and Medicaid DSH payments
  • Familiar with Medicare Provider Reimbursement Review Board (PRRB) Appeal Process
  • Advanced level knowledge of Microsoft Excel and/or Microsoft Access
  • Working knowledge of THR Hawkeye DSH software is preferred
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