Director Medicaid Reimbursement

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.
• Maintains 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.
• Communicates technical positions and arguments effectively to Medicaid auditors to support positions.
• Leverages reimbursement expertise to identify strategic opportunities supporting long-term reimbursement optimization and sustainability.
• Proposes year-end estimated Medicaid third-party financial settlements to be audited by AdventHealth’s external auditor for inclusion in the audited financial statements.
• Proactively seeks to improve strategy and reduce risks, including 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.
• Ensures that the potential of future take-backs is understood, communicated, and managed appropriately.
• Educates Finance, Revenue, Cycle & Operational Leaders on regulations and impacts.
• Communicates with key stakeholders on opportunities and impact, regarding current issues as well as fundamentals of reimbursement for those in new roles.
• Provides strategic thinking to identify new reimbursement mechanisms, ensuring the proper development, management, and optimization of existing programs while identifying when and whether to join appeal cases.
• Consults with leadership, providing guidance on ensuring stability of existing programs and strategic options to consider, to fulfill our mission.
• Provides mentoring and coaching to staff, develops future financial leaders, and recruits top-tier talent.
• Utilizes excellent communication skills, including adjusting or adapting messaging for different stakeholders.
• Participates in and/or leads special projects as assigned.

Benefits

• Medical, Dental, Vision Insurance
• Life Insurance
• Disability Insurance
• Paid Time Off from Day One
• 403-B Retirement Plan
• 4 Weeks 100% Paid Parental Leave
• Career Development
• Whole Person Well-being Resources
• Mental Health Resources and Support
• Pet Benefits

Position Details

Schedule: Full time
Shift: Day
Location: 900 Hope Way, Altamonte Springs, FL 32714

Education

• Bachelor’s Degree (Required)
• Master’s Degree (Preferred)

Field of Study

• 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 a management role (Preferred)
• Strong background in accounting and financial analysis (Required)

Licenses and Certifications

• Certified Public Accountant (CPA) (Preferred)

Physical Requirements

Work requirements are available at

Pay Range

$146,405.57 - $272,307.13

Equal Opportunity Employment

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.