Director - Reimbursement

Description

Management/Leadership
Req #: 54420

Summary:
Assists the Vice President, Reimbursement in departmental planning in order to achieve departmental goals and supervision. Develops rate structure and monitors compliance with federal regulatory programs. Monitors implications of all proposed governmental and third party reimbursement changes. Reviews and/or estimates the budgeted net patient service revenue for assigned facilities and assists with other facilities as needed. Coordinates, controls, and manages the preparation of interim and year end cost reports and analyses related to governmental reimbursement for all MaineHealth facilities; Supervises and coordinates activities related to reviews and audits by the Medicare Administrative Contractor (MAC) and governmental organizations for assigned facilities and provides assistance to other facilities as needed; Coordinates with the Vice President to ensure that MaineHealth is achieving the optimal reimbursement under existing regulations and is prepared for all proposed regulations.

Required Minimum Knowledge, Skills, and Abilities (KSAs)

1. Education: Bachelor degree in Accounting, Finance, Business Administration or related field in order to provide the necessary technical direction and management. MBA degree or HFMA or CPA certificate is preferred.
2. License/Certifications: "See Education"
3. Experience: Seven or more years of experience in reimbursement and Medicare/Medicaid cost reporting is required with at least three years of hospital management experience.
4. A high level of problem solving skills necessary in order to develop and implement new procedures and techniques and prepare special and recurring reports and analyses.
5. A high level of interpersonal skills necessary in order to deal with complex situations with a wide variety of internal and external personnel and to make fact based presentations before groups, including regulatory agencies.

If you have questions about this role, please contact matthew.tzuker@mainehealth.org