Sys Manager Reimbursement-Government Programs Appeals

About the role

The System Manager, Reimbursement will provide executive leadership, management, and coordination related to the government reimbursement services of CommonSpirit. This pivotal role ensures timely and accurate financial and governmental reporting, critically managing our reimbursement program according to relevant policy terms and conditions within the complex healthcare landscape.

You will identify and implement innovative strategies, policies, procedures, and programs for all aspects of reimbursement management practices. You will proactively monitor and communicate federal and state regulatory proposals and changes regarding healthcare reimbursement, providing effective solutions to address evolving reimbursement service needs. Additionally, you will oversee, evaluate, and continuously improve the productivity and performance of our dedicated reimbursement staff members.

Responsibilities

• Manages the organization's reimbursement activities, ensuring timely and accurate financial reporting, and implements related strategies, policies, and procedures.
• Maintains knowledge of Medicare/Medicaid cost reporting, actively reviews and assists with hospital cost reporting, and prepares for third-party audits.
• Applies financial analysis tools and accounting methods to read, interpret, and maintain accurate financial statements and reports, including monthly net revenue reviews.
• Monitors and communicates federal and state regulatory changes in healthcare reimbursement, providing effective solutions to address associated issues.
• Oversees, evaluates, and continuously improves the productivity and performance of reimbursement staff members.
• Understands state supplemental programs (including projections and bookings), works with State Hospital Associations, and ensures compliance with federal, state, and local healthcare regulations.

Requirements

• Bachelor's Degree in Accounting, Finance, Business Administration or related field.
• Minimum of five (5) years of intensive experience with Medicare and Medicaid reimbursement.
• Two (2) years of net revenue experience.
• Minimum of two (2) years of management experience.

Qualifications

• Prior experience in healthcare finance and government reimbursement methodologies.
• Exceptional analytical skills.
• Demonstrated ability to develop and lead high-performing teams in a large healthcare system.

Skills

• Strong leadership and communication skills.
• Ability to manage multiple priorities and deadlines.
• Knowledge of healthcare regulatory compliance.
• Proficiency in financial analysis and reporting tools.

Benefits

CommonSpirit Health offers a comprehensive benefits package, including medical, prescription drug, dental, vision plans, life insurance, paid time off, tuition reimbursement, retirement plans, and more. For more information, please visit our Total Rewards page.

Pay

The posted compensation range of $54.76 - $90.35 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.

Schedule

The System Manager, Reimbursement will work a full-time schedule of 80 hours per pay period, Monday through Friday, with a remote option.