By joining our team, you'll be part of our life-changing Mission and Vision. You'll work in a truly inclusive environment where diversity and equity are championed through words and actions. You'll contribute to an innovative culture that is second to none, one that embraces curiosity, discovery and compassion. You'll play a role in something that's never been done before as we integrate science and clinical care to help patients achieve better, faster outcomes - as we Advance Human Ability, together.
Job Description Summary
The Director, Reimbursement and Financial Analysis will serve as an expert to senior leadership on all reimbursement methodologies and trends. The Director The Director, Reimbursement and Financial Analysis will serve as an expert to senior leadership on all reimbursement methodologies and trends. The Director will partner with Revenue Cycle Operations leadership to provide financial and analytic support and ensure proper accounting of accounts receivables. They will lead payor analytics for the contracting team and develop and maintain financial models related to potential changes in federal programs or managed care. Proactively identifies opportunities for revenue growth based on changing regulations. The Director will play a lead role in the preparation, submission, and management of Medicare and Medicaid cost reports for the hospital.
The Director, Reimbursement and Financial Analysis will consistently demonstrate support of the Shirley Ryan AbilityLab statement of Vision, Mission and Core Values by striving for excellence, contributing to the team efforts and showing respect and compassion for patients and their families, fellow employees, and all others with whom there is contact at or in the interest of the institute.
The Director, Reimbursement and Financial Analysis will demonstrate Shirley Ryan AbilityLab Core Attributes: Communication, Accountability, Flexibility/Adaptability, Judgment/Problem Solving, Customer Service and Core Values (Hope, Compassion, Discovery, Collaboration, & Commitment to Excellence) while fulfilling job duties.
Job Description
The Director, Reimbursement and Financial Analysis will:
Serve as central connection point between Finance, Accounting, and Revenue Cycle leadership
Direct the development and implementation of reimbursement strategies across all payor types including Medicare, Medicaid, and commercial insurance
Monitor legislative and regulatory changes affecting Medicare/Medicaid reimbursement, model and communicate expected impact, and implement necessary strategies
Through partnership with a third party, generate and analyze detailed AR reports using RCA software to identify trends, bottlenecks, and manage the net AR month end accounting close process
Play key role in the development, review, and submission of annual Medicare/Medicaid cost reports, ensuring accuracy and compliance with CMS guidelines and regulations
Coordinate with external auditors during Medicare/Medicaid audits and respond to audit findings
Implement and manage Medicare bad debt policy and procedures.
Analyze KPIs for accounts receivable, bad debt, denials, and collection rates
Provide financial & strategic support in payor contract negotiations to optimize payment terms
Assist in the review of annual CDM price increase process
Provide reimbursement expertise in strategic financial modeling (new partnerships, expansion, etc.)
Present complex financial information to senior leadership and provide strategic recommendations
Lead financial forecasting, budgeting, and reporting for revenue cycle operations
Reporting Relationships
Knowledge, Skills & Abilities Required
Bachelor's degree in Healthcare Administration, Finance, or related field
Master's degree in related field and/or CPA preferred
Background in hospital financial operations with 10+ years of healthcare experience, with at least 5 of those years in a reimbursement role being strongly preferred; advanced degrees and/or specific relevant experience can substitute for total years of experience.
Comprehensive knowledge of CMS regulations, cost reporting principles, and healthcare reimbursement methodologies
Working knowledge of the full Revenue Cycle process and implications on net revenue and accounts receivable valuation
Familiarity with healthcare billing and coding practices and technologies
Experience in Medicare Cost Report preparation and review.
Experience with RCA software for AR accounting and analysis
Strong understanding of hospital operations and healthcare financial management
Experience with electronic health record (EHR) systems
Excellent analytical and problem-solving abilities
Strong interpersonal and negotiation skills
Ability to communicate effectively and work collaboratively with all levels of the organization
Full understanding of accounting principles relating to revenue and accounts receivable
Ability to manage multiple priorities in a fast-paced environment
Working Conditions
Pay and Benefits :
Pay Range: $128,480.00 annually - $213,297.00 annually
Benefits: Shirley Ryan AbilityLab offers a comprehensive benefits program that is competitive with our industry peers in our geographic locations:
Benefits and benefits' eligibility can vary by position. Actual compensation will vary based on applicant's experience and qualifications, as well as internal equity.
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.
Equal Employment Opportunity
ShirleyRyan AbilityLab is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.