Employment Type:

Shift:

Description:

POSITION PURPOSE

Provides consultation leadership and managerial direction to the reimbursement function for multiple RHMs exceeding $600 million in net revenue. Manages net revenue calculations filing cost reports third-party and year end audits and reporting and reconciling general ledger accounting for third party payments and settlements. Identifies all financial and compliance risk associated with the RHMs reimbursement function keeps Regional Director apprised of identified risk and develops risk management plans. Works closely with and supports other revenue functional areas including payer negotiations and contracting patient financial services utilization management and coding. Serves as a consultative resource and develops establishes and manages relationships with executive leaders key stakeholders high-level professionals and decision makers. Manages and oversees team members work assignments provides technical specialized leadership and guidance in coordinating projects managing deliverables and ad-hoc problem resolution and troubleshooting.

ESSENTIAL FUNCTIONS

Knows understands incorporates and demonstrates the Trinity Health Mission Vision and Values in behaviors practices and decisions.

Manages all financial and compliance risk associated with the MO reimbursement function notifies departmental leadership of identified risks; and develops and implements risk management plans.

Manages and oversees project initiatives/teams having a regional and/or system focus and impact. Defines and manages project plans and goals; conducts business workflow mapping; impact analyses and modeling. Provides and monitors assignments of team members. Provides leadership and seasoned guidance coordinating projects adhering to established methodology managing deliverables addressing risk factors and providing problem resolution in meeting project plan deliverables.

Responsible for hiring retaining evaluating mentoring and firing staff within the RHM reimbursement staff.

Manages the preparation of RHMs net revenue calculations for review with the Chief Financial Officers prior to financial statement due date. Manages the preparation of the budgeted net revenue calculation for the RHMs.

Manages the preparation of RHMs cost reports and other third-party filings.

Manages the preparation for third party audits resolves audit issues and supports developing appeals.

Monitors policies and procedures to ensure reimbursement procedures practices and reporting adhere to compliance regulations.

Manages the reporting process and reconciliation of general ledger accounting for third party payments and settlements including third party payor receivables payables and reserves.

Provides education and consultation to staff to ensure the accuracy of third-party reporting. Maintains expertise in reimbursement strategies through appropriate educational and organization activities and serves as a resource for all reimbursement staff.

Manages the year-end audit preparation for reimbursement issues ensuring the continued integrity of financial records through the design and implementation of appropriate controls.

Provides seasoned guidance and proven competence in interfacing with executive leaders stakeholders and high-level professionals. Develops and maintains effective relationships with leaders stakeholders high level professionals and decision makers to support system initiatives and ensures the successful implementation of goals and objectives.

Facilitates meetings with executive leaders key stakeholders and decision makers by gathering/exchanging information coordinating communications and making presentations. Responsible for researching and compiling detailed information from multiple sources and preparing materials which may include the development of new policies processes and opportunities.

Identifies and prepares operational and financial metrics and provides appropriate interpretation and application of data. Designs develops and implements systems that provide financial statistical and operational information.

Participates in RHM management and staff meetings to provide reimbursement support.

Represents RHMs when reporting to and dealing with external agencies such as the Centers for Medicare and Medicaid Services (CMS) third party payors federal regulatory agencies and other health care entities regarding reimbursement practices policies and regulations.

Promotes change in public and private sector policies and procedures in order to optimize the performance of RHMs while maintaining consistency with the TH mission and values.

Participates in the ongoing review and monitoring of contracts with third party payors and managed care entities.

Assists departments to enhance their understanding of hospital reimbursement.

Maintains a working knowledge of applicable Federal State and local laws and regulations the Trinity Health Corporate Integrity Program Code of Ethics as well as other policies and procedures in order to ensure adherence in a manner that reflects honest ethical and professional behavior.

MINIMUM QUALIFICATIONS

Bachelors degree in Accounting or Finance or an equivalent combination of education and experience. A Masters degree is preferred.

Certification as a Certified Public Accountant (CPA) is preferred.

Minimum seven (7) to ten (10) years of progressively more responsible experience in health care reimbursement or equivalent experience in general finance including finance management. Previous managerial experience is preferred.

Experience in researching and analyzing complex reimbursement issues. Possesses deep analytical quantitative evaluative and problem-solving skills.

Ability to manage projects having a system-wide scope of responsibility and impact to develop and maintain effective collaborative relationships and partnerships with leaders stakeholders and decision makers. Strong planning evaluative organizing and problem-solving skills to integrate activities that are relatively homogenous or diverse in nature.

Strong interpersonal consultative relationship and consensus building skills to effectively facilitate teams/committees and interface with executive leaders key stakeholders and decision makers. Ability to influence results garner support and tactfully manage complex relationships across the enterprise. Ability to read the subtle nuances of situations and react/plan accordingly.

Excellent oral and written communication skills. Ability to facilitate communications between diverse groups. Ability to effectively identify assess and facilitate improvements and solutions and present advisory and persuasive recommendations.

Considerable knowledge and experience supporting and developing reporting and analytics for research process improvement/change management support and specific revenue management function. Ability to develop appropriate methods to collect analyze and report data.

Advanced proficiency with Microsoft product suite (MS Word Excel Power Point Access and Visio) and standard project management software (i.e. spreadsheets databases graphics presentation tools etc.).

Strong attention to detail and organizational skills. Demonstrated ability to manage multiple concurrently running projects and adapt to changing deadlines competing priorities and unexpected assignments.

Demonstrated ability to respect confidential and sensitive information understanding and honoring lines of accountability and communication is essential.

Ability to work effectively in a matrix organizational structure and influence others.

Must be comfortable operating in a collaborative shared leadership environment.

Must possess a personal presence that is characterized by a sense of honesty integrity and caring with the ability to inspire and motivate others to promote the philosophy mission vision goals and values of Trinity Health.

PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS

Ability to develop constructive alternatives and analyze situations and information.

Ability to work well in a fast-paced setting that warrants varied and/or extended hours with frequently changing workload and priorities in order to keep pace with the environment and advance strategic priorities.

Must be able to set and organize own work priorities and adapt to them as they change frequently.

This position operates in a typical office environment free from hazard and barriers. Manual dexterity is needed in order to operate a computer and calculator.

Must be able to travel to the various Trinity Health sites (20%) as needed.

The above statements are intended to describe the general nature and level of work being performed by persons assigned to this classification. They should not be construed as an exhaustive list of duties so assigned.

Our Commitment

Rooted in our Mission and Core Values we honor the dignity of every person and recognize the unique perspectives experiences and talents each colleague brings. By finding common ground and embracing our differences we grow stronger together and deliver more compassionate person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin disability veteran status or any other status protected by federal state or local law.