Director, Reimbursement - Health System Reimbursement - hybrid role (#1 Hospital in CA)

About the role

The Director of Reimbursement provides leadership, management, and coordination of government reimbursement for multiple hospitals within the health system. This role ensures timely and accurate financial and governmental reporting by managing the reimbursement team consistent with regulatory guidelines.

Responsibilities

• Ensures timely and accurate completion of financial reporting by effectively managing the reimbursement team in accordance with relevant regulatory and policy guidelines.
• Oversees multiple filing requirements including state, federal and private industry reporting (Medicare, Medi-Cal, HCAI, NIH, AHA, etc.).
• Maintains compliance with all applicable state and federal regulatory guidelines related to financial reporting.
• Manages the productivity, development, and performance of the reimbursement team, ensuring adherence to budget targets and maintaining compliance with all applicable internal policies and procedures.
• Monitors and communicates federal and state regulatory proposals regarding healthcare reimbursement and provides effective briefings and impact assessments as needed for multiple constituent groups including executive management.
• Coordinates with consultants and both internal and external counsel concerning regulatory appeals, special projects, and other reporting matters at the health system level.
• Manages audit responses and provides guidance as needed for all relevant external and internal audit reviews, including those conducted by Medicare, Medi-Cal, National Institutes of Health (NIH), Office of Inspector General (OIG), and other agencies, as well as the health system’s annual financial audit.
• Prepares annual reporting for the National Institutes of Health regarding research funding for indirect rate and fringe benefit reimbursement.
• Identifies and implements strategies, policies, and procedures related to all aspects of reimbursement management.

Qualifications

• Education: Bachelor's degree - minimum - Finance, accounting, or other relevant field with appropriate combination of education and experience.
• Work Experience: 3 years - minimum - Leadership experience with Medicare and Medicaid (Medi-Cal) reimbursement showing leadership progression within a relevant organization. 5 years - preferred - Leadership experience with Medicare and Medicaid (Medi-Cal) reimbursement in a large academic medical center or health system environment.

This hybrid role requires a minimum of two days per week in the office.