Director - Reimbursement

  • MaineHealth
  • Portland, ME, USA
  • Jan 05, 2021

Job Description

Summary

Position Summary

Assists the Vice President, Reimbursement in departmental planning in order to achieve departmental goals and supervision. Manages the hospital's preparation and submission of cost reimbursement reports to government and private third party agencies. Develops rate structure and monitors compliance with federal regulatory programs. Monitors implications of all proposed governmental and third party reimbursement changes.

Participates in the contractual allowance portion of the Long Range Financial Plan. At the System level: 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; Coordinates with the Vice President to ensure that MaineHealth is achieving the optimal reimbursement under existing regulations and is prepared for proposed regulations.

Required Minimum Knowledge, Skills, and Abilities (KSAs)

  • Knowledge of advanced accounting and reimbursement principles normally acquired through completion of a Bachelor degree program in Accounting, Finance, Business Administration or related field in order to provide the necessary technical direction and management.
  • 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.
  • MBA degree or HFMA or CPA certificate is preferred.
  • 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.
  • Five to ten years of experience in reimbursement and Medicare/Medicaid cost reporting is required with at least three years of hospital management experience.