Director of Revenue & Reimbursement

About the role

The Director, Revenue and Reimbursement oversees the day-to-day operations of the Revenue and Reimbursement area at Dana-Farber Cancer Institute. This includes managing more than $3B of Patient Revenue, filing Medicare and State cost reports, and strategic decision-making regarding balance sheet reserves.

Responsibilities

• Annual budgeting, forecasting, accounting, summarizing, and communicating the results, variances, and reconciliations of more than $3B of annual Patient Revenue and associated patient related volume.
• Work closely with various clinical division administrators during operational planning and clinical budgeting and revenue modeling process.
• Career development and management of staff to achieve organizational goals.
• Present analysis to Senior Financial Management on related actual to budget variances, volume trends, etc.
• Manage analysis and completion of benchmarking, surveys, and other competitive data for both internal and external customers.
• Interface and collaborate with Financial Planning and Accounting staff, Senior Management, and department managers, to produce clinical and financial ad hoc reports and analyses.
• Participate in committees and teams related to rate sensitivity reviews, revenue enhancements, revenue cycle, improved charge capture.
• Perform continuous review of Revenue and Reimbursement functions and business processes for streamlining opportunities and improvements to operational efficiency.

Requirements

• Bachelor's Degree in accounting, finance, or related field, Master's Degree preferred in business administration or equivalent.
• 8 years of relevant healthcare industry work experience with at least 5 of those years spent in a supervisory capacity in a hospital environment.
• Experience with inpatient and outpatient cost reporting of complex health systems.
• Experience with the overall finances of novel and high-end therapies like CAR-T, Theranostics, and Bone Marrow/Stem Cell transplants.

Qualifications

• Expert knowledge of hospital payment methodologies for inpatient and ambulatory treatments, government and commercial payors, PPS and PPS exempt payment methodologies, including experience with oncology services.
• Expertise and a high-functioning knowledge of the Medicare cost report and cost-based reimbursement.
• Strong demonstrated ability to develop, manage, and maintain relationships, including the ability to effectively negotiate with representatives from governmental and commercial payors, external auditors, consulting and legal representatives, and industry experts.
• Excellent interpersonal and communication skills to effectively collaborate and communicate with all levels of internal staff remotely.
• Excellent working knowledge of the mechanics of drug expense and revenue in a hospital setting.