Director of Reimbursement And Regulatory Compliance
Director of Reimbursement And Regulatory Compliance
Employer Active
Job Alert
You will be updated with latest job alerts via email
Share
Job Alert
You will be updated with latest job alerts via email
$ $ 98200 - 117837
1 Vacancy
Job Description
Director of Reimbursement & Regulatory Compliance
Location: Clinton MO
Schedule: Fulltime Monday Friday 8:00 AM 5:00 PM No weekends
Position Overview:
We are seeking a Director of Reimbursement & Regulatory Compliance to oversee all aspects of Medicare and Medicaid cost reporting Disproportionate Share Hospital (DSH) funding and regulatory compliance for a Sole Community Rural Hospital (SCH) and its providerbased clinics. This role is critical in ensuring compliance with federal and state regulations while developing financial strategies to optimize hospital and clinic reimbursement.
Key Responsibilities:
Reimbursement & Financial Reporting
- Oversee the preparation submission and analysis of Medicare and Medicaid cost reports for the hospital and providerbased clinics.
- Ensure the hospital maintains Sole Community Hospital (SCH) designation benefits and meets all eligibility requirements.
- Manage DSH and Uncompensated Care reporting ensuring accurate documentation to maximize financial recovery.
- Monitor and optimize rural health clinics (RHC) and providerbased billing for compliance and maximum reimbursement.
- Lead financial modeling and forecasting to assess reimbursement impacts.
Legislative & Regulatory Compliance
- Track federal and state regulatory changes affecting hospital and clinic reimbursement including 340B Medicaid and Medicare payment policies.
- Advocate for hospital interests by collaborating with state hospital associations legislators and industry groups on rural hospital funding issues.
- Ensure compliance with Medicare Bad Debt reporting wage index adjustments and other reimbursementrelated regulations.
Audit & Risk Management
- Serve as the primary point of contact for cost report audits Medicaid DSH audits and other financial compliance reviews.
- Implement internal controls and audit strategies to reduce financial risk and enhance compliance.
- Collaborate with external auditors and consultants to support reimbursement initiatives.
Strategic & Operational Collaboration
- Partner with hospital leadership CFO revenue cycle and compliance teams to develop financial sustainability strategies.
- Educate internal teams on reimbursement trends rural hospital policies and compliance requirements.
- Assist in the development of new providerbased clinics ensuring proper regulatory setup for costbased reimbursement eligibility.
Qualifications:
- 5 years of experience in healthcare reimbursement finance or compliance (preferably in a rural hospital setting).
- Bachelors degree required in Accounting Finance Healthcare Administration Business Administration or Economics.
- Experience with rural hospital funding models Medicaid programs and statespecific reimbursement initiatives.
- Strong knowledge of Medicare and Medicaid regulations cost reporting and financial forecasting.
Compensation & Benefits:
- Base Salary: $98200 (with experiencebased increases up to $117840).
- Employee Incentive Bonus based on hospital performance and patient satisfaction.
- Retirement Contribution: 06% annual employer contribution (403(b) no match).
- Health Vision and Dental Insurance with stable premiums.
- Paid Time Off (PTO): Starting with 12 hours of PTO per month.
- Employee Discounts: 20% discounts on hospital services.
- Supportive familylike work culture with opportunities for career growth and development.
Why Join Our Client
This is an exciting opportunity to make a direct impact on the financial health and sustainability of a rural healthcare system. If you have strong expertise in healthcare reimbursement and regulatory compliance and youre looking for a leadership role with stability growth and meaningful work we encourage you to apply!
Employment Type
Full Time
