CHIEF, REVENUE MANAGEMENT, HEALTH SERVICES (MEDICARE PROGRAMS DIRECTOR)

About the role

The Los Angeles County Department of Health Services (DHS) seeks a Chief, Revenue Management, Health Services to administer, plan, direct, and manage revenue and other finance functions of the department.

Responsibilities

• Administers, plans, directs, and manages revenue and other finance functions of the Department of Health Services (DHS).
• Plans and directs the day-to-day centralized finance operations, including cost accounting, general accounting, or invoice processing.
• Directs the activities related to preparation and filing of the hospital Medicare cost reports, as well as the creation of amendments and/or reopening requests on timely basis, adhering to legal deadlines.
• Directs the facilitation of the Medicare cost reports and Wage Index audits, which includes participation in entrance/exit conferences and other engagements with the Medicare Administrative Contractor (MAC), ensuring adequate documentation is provided to address the auditors’ questions/inquires to prevent audit adjustments.
• Directs the preparation and submission of timely appeals, participates in negotiating resolutions with the MAC, reviews tentative settlements.
• Collaborates with the legal counsel on strategies and documentation to support County’s position during the appeal processes, both at an administrative and formal levels.
• Directs the development of technical analysis and financial models to support strategic initiatives, business ideas, and policy impacts involving Medicare add-on payments, such as Medicare Disproportionate Share Hospital (DSH), Indirect Medical Education (IME), Graduate Medical Education (GME), and other supplemental or special payment programs.
• Serves as a subject matter expert on Medicare reimbursement methodologies and supports hospitals’ compliance with complex financial and regulatory requirements.
• Participates and assists in negotiations, contracting, and drafting of the Medical School Affiliation Agreements and GME Agreements.
• Meets with the legal and consultant teams to evaluate new/revised Medicare regulation requirements and the impact on the DHS’ financial operations; develops strategies and action plans to implement the policies.
• Lead and manage teams, provides developmental feedback, and advances internal initiatives.
• Completes administrative requirements of the role in a punctual manner, including training, reporting, forecasting, and all other time-sensitive administrative duties.

Requirements

• Bachelor’s degree from an accredited college or university* in Finance, Accounting, Business Administration, Healthcare Administration, or related fields -AND- Three (3) years of experience in directing one or more of the following complex health care fiscal operations: budgetary projections or reporting; revenue programs; patient, general, or cost accounting; cost reporting; revenue enhancement strategy development; revenue cycle operations; or other major finance-related areas.
• OR- Bachelor’s degree from an accredited college or university* in Finance, Accounting, Business Administration, Healthcare Administration, or related fields -AND- One (1) year of experience at the level** of Revenue Manager l*** or higher within a finance division in the County of Los Angeles.
• Additional credit will be given to applicants that possess the following desirable qualifications:
• Additional experience in excess of the Requirements.
• Experience in Medicare reimbursement, Medicare cost reporting, Healthcare consulting, or Cost report auditing, including analyzing reimbursement methodologies, preparing or reviewing cost reports, and ensuring compliance with applicable regulatory requirements.
• Experience performing Medicare consulting or audit activities with a Medicare Administrative Contractor (MAC), including evaluating compliance, reviewing claims or reimbursement processes, and providing recommendations for operational or regulatory improvement.
• Master’s degree* in Health Administration, Business Administration in Healthcare, Healthcare Management, or Public Health.

Qualifications

• PHYSICAL CLASS 2 – Light
• This class includes administrative and clerical positions requiring light physical effort that may include occasional light lifting to a 10-pound limit and some bending, stooping, or squatting. Considerable ambulation may be involved.
• Licenses: A valid California Class C Driver License or the ability to use an alternative method of transportation when needed to carry out job-related essential functions.

Desirable Qualifications

• Additional experience in excess of the Requirements.
• Experience in Medicare reimbursement, Medicare cost reporting, Healthcare consulting, or Cost report auditing, including analyzing reimbursement methodologies, preparing or reviewing cost reports, and ensuring compliance with applicable regulatory requirements.
• Experience performing Medicare consulting or audit activities with a Medicare Administrative Contractor (MAC), including evaluating compliance, reviewing claims or reimbursement processes, and providing recommendations for operational or regulatory improvement.
• Master’s degree* in Health Administration, Business Administration in Healthcare, Healthcare Management, or Public Health.