Manager of Reimbursement Strategy, Analysis and Forecasting
Manager of Reimbursement Strategy, Analysis and Forecasting
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$ 89648 - 107578
1 Vacancy
Job Description
Manager of Reimbursement Strategy Analysis and Forecasting
- Salary Range:$89648 - $107578 based on relevant years of experience
- Location: Larimer county Colorado
- Status:(example full time 40 hours per week)
- Hours:Monday-Friday
Role Overview:
The Manager of Reimbursement Strategy Analysis and Forecasting is a strategic leadership role responsible for data-driven insight aligning the organizations operational oversight related to payer reimbursement revenue modeling and financial performance. This role is essential to maximizing the organizations understanding of and responsiveness to evolving reimbursement models including Medicaid commercial grant-funded and value-based arrangements and ensures effective participation in risk-based and prospective payment systems. This position plays a key role in analyzing payment methodologies forecasting revenue and developing financial strategies that ensure sustainability and support the mission of delivering high-quality behavioral health services. The position works closely with Finance Clinical Operations Revenue Cycle and Executive Leadership to integrate reimbursement intelligence into budgeting forecasting and decision-making processes.
Essential Duties:
- Reimbursement Strategy and Analysis
- Serve as the organizations lead expert on payer reimbursement including prospective payment systems (PPS) capitation fee-for-service and value-based care models.
- Monitor regulatory and legislative activity affecting Medicaid policy and analyze the financial impact of current and proposed payment methodologies andrecommend organizational responses.
- Support contract negotiation and program development with reimbursement modeling and revenue projections.
Financial Planning and Forecasting
- Lead multi-year revenue forecasting and financial planning processes incorporating reimbursement trends and payer dynamics.
- Integrate cost volume and payment data into comprehensive program financial plans.
Decision Support and Revenue Modeling
- Design and maintain financial models and dashboards to inform leadership on the financial impact of reimbursement policies service mix and operational performance.
- Provide scenario planning for new payer models rate changes or policy shifts.
- Evaluate financial risk and return associated with entering into new reimbursement arrangements pilots or strategic partnerships.
Cross-Functional Collaboration and Leadership
- Work closely with the CFO Executive and Senior Leadership Teams to align financial planning with organizational goals and funding environment.
- Communicate complex financial information and reimbursement issues clearly to non-financial stakeholders.
Stakeholder Engagement and Advocacy
- Liaise with state Medicaid agencies managed care organizations associations (e.g. CBHC) and external consultants on payment model developments.
- Monitor regulatory and legislative activity affecting behavioral health reimbursement and recommend organizational responses.
Required:
- Bachelors degree in accounting Finance Analytics Economics or a related field (or equivalent experience); masters degree or CHFP certification preferred.
- Minimum 7 years of progressive experience in healthcare finance reimbursement analysis or payer contracting; behavioral health or Medicaid focus preferred.
- Strong knowledge of healthcare reimbursement models financial forecasting and planning tools.
- Proficient in financial modeling Excel and business intelligence platforms (e.g. Power BI).
- Exceptional analytical communication and leadership skills.
Preferred Qualifications:
- Experience in community mental health FQHCs or safety-net healthcare systems; familiarity with Colorado Medicaid and behavioral health integration strongly preferred.
- Proven ability to communicate complex financial concepts to executives and external stakeholders.
- Demonstrated success in strategic planning project management and cross-functional collaboration.
- Skilled in proactive problem-solving service-oriented communication and driving continuous improvement.
- Experience in fast-paced policy-driven environments; consulting or multi-site healthcare systems experience a plus.
- Bilingual/bi-cultural preferred
Total Rewards
At SummitStone Health Partners we are proud to offer a comprehensive and competitive benefits package designed to support the well-being of our team members. Eligibility and pro-rated benefit levels are based on FTE (full-time equivalent) status.
Below are some of the benefits we offer:
- Medical dental and vision coverage including options for eligible dependents
- Mental health and wellness resources
- Short-term and long-term disability insurances
- Paid time off (PTO): Accrued vacation and personal leave based on FTE status and length of service
- Paid Sick Leave: Provided in accordance with the Colorado Healthy Families and Workplaces Act (HFWA)
- A range of voluntary benefits available to all employees
- 403(b) retirement plan with employer matching contributions
Reach Out
SummitStone will provide persons with disabilities with reasonable accommodations. If reasonable accommodation is needed to participate in the job application or selection process please let your recruiter know.
Questions Please email us at
This position will be open for a minimum of three days and/or until a top candidate is identified.
Required Experience:
Manager
Employment Type
Full Time
