Manager, Reimbursement and Cost Reporting

About the role

The Manager, Reimbursement and Cost Reporting is responsible for providing support in the preparation of cost reports, reimbursement compliance and research, reimbursement studies and other related financial analysis for the Hackensack Meridian Health (HMH) network. Responsibilities include the preparation of advanced sections of the Medicare and NJDOH cost reports, completion of advanced reimbursement studies and models (PPS Rate calculations, IME/GME, APC Rate calculations, etc.), audit coordination and support staff supervision and training. Also responsible for Monthly Medicare reconciliation and assists in completion of monthly third party review. Will have Network responsibilities for coordination and execution of reimbursement analysis, strategic modeling, appeal development and execution, regulatory research and summation, managing third party auditors and big data analytics. Also has oversight responsibility for the completion of cost reports for a dedicated region.

Responsibilities

• Coordinates and oversees the accurate and timely completion of the Medicare and NJ Acute Care Hospital cost reports while also providing assistance to the team
• Directs the preparation of the GME IRS filing
• Develops the third party governmental appeal strategies and initiatives; tracks success of re-openings and appeals
• Coordinates, analyzes and communicates an assigned topic/issue on a Network-wide basis to include, but not limited to: Appeal and Re-opening Management; Charity Care & GME Subsidies; Third Party Roll Forward Analyses; DSRIP Programs; and/or Wage Index modelling
• Acts as a champion for DSRIP programs by educating key stakeholders, monitoring success, and identifying opportunities for improvement
• Coordinates assembly of the Medicaid DSH Surveys while also providing assistance to the team
• Maintains and organizes the supporting work paper documentation for the manager/director reviews; final work papers used for all cost reports and DSH Surveys should be printed and maintained for historical reference
• Facilitates the cost report process by creating worksheets, identifying data sources and gathering departmental information as needed, including developing new processes, worksheets or information requirements as necessary
• Effectively communicates requirements, verbally and in writing, with various departments to ensure timely and accurate data collection
• Coordinates Medicare/Medicaid audits with the CMS Intermediary as well as any audits for the NJACH cost reports while acting as a liaison between the hospital and the in-charge auditor; reviews proposed audit adjustments and communicates with the auditor and manager regarding any questions or concerns relating to the adjustments proposed
• Provides the coordination of the department's role in off-site reviews and moves by completing the necessary CMS 855's and State required financial information required by Federal and State agencies on a timely basis
• Researches via the internet (MediRegs), relevant publications and/or manuals, various reimbursement compliance issues and strategies; studies new regulations as they emerge and seeks out relevant research
• Provides support in the supervision, coordination and education of the staff particularly during peak reporting periods
• Ensures appropriate reports are downloaded and information obtained relating to outliers and third party reports; researches variances until resolved
• Completes all other necessary duties with attention to detail and in a timely manner including the Wage Index, Occupational Mix Survey and other relevant financial analysis relating to reimbursement issues as requested
• Maintains high integrity work papers in a paperless business intelligence work environment
• Assists the Budget Teams with various analyses and tasks when requested
• Other duties and/or projects as assigned
• Adheres to HMH's Managerial competencies and standards of behavior

Requirements

• Bachelor's degree in Accounting/Finance
• Four or more years of progressive reimbursement related experience in a large health network and/or academic medical center
• Advanced proficiency in using technology that includes but is not limited to Microsoft Office (Excel, Outlook, etc.), Axiom and PeopleSoft Financials System
• Strong interpersonal, team and organizational skills
• Proven record of progressive professional growth and responsibility
• Strong analytical and problem solving skills
• Excellent written and verbal communication skills

Qualifications

• CPA and/or MBA (Preferred)

Pay

Minimum rate of $133,120 Annually. HMH is committed to pay equity and transparency for our team members. The posted rate of pay in this job posting is a reasonable good faith estimate of the minimum base pay for this role at the time of posting in accordance with the New Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package. The starting rate of pay is provided for informational purposes only and is not a guarantee of a specific offer. Posted hourly rates may be stated as an annual salary in the offer and posted annual salaries may be stated as an hourly rate in the offer, depending on the level and nature of the job duties and credentials of the candidate. The base compensation determined at the time of the offer may be different than the posted rate of pay based on a number of non-discriminatory factors, including but not limited to:

• Labor Market Data: Compensation is benchmarked against market data to ensure competitiveness
• Experience: Years of relevant work experience
• Education and Certifications: Level of education attained, including specialized certifications, credentials, completed apprenticeship programs or advanced training
• Skills: Demonstrated proficiency in relevant skills and competencies
• Geographic Location: Cost of living and market rates for the specific location
• Internal Equity: Compensation is determined in a manner consistent with compensation ranges for similar roles within the organization
• Budget and Grant Funding: Departmental budgets and any grant funding associated with the job position may impact the pay that can be offered

Some jobs may also be eligible for performance-based incentives, bonuses, or commissions not reflected in the starting rate. Certain positions may also be eligible for shift differentials for work performed on evening, night, or weekend shifts.

Benefits

In addition to our compensation for full-time and part-time (20+ hours/week) job positions, HMH offers a comprehensive benefits package, including health, dental, vision, paid leave, tuition reimbursement, and retirement benefits.