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Providence Health & Services Senior Manager Reimbursement – Regulatory Reporting in Burbank, California

Description:

Providence St. Joseph Health is calling a Senior Manager Reimbursement – Regulatory Reporting to our location in Renton, WA.

The Senior Manager Reimbursement – Regulatory Reporting is responsible for execution of various strategic value-added reimbursement initiatives for the system to include evaluation, planning, coordination, and follow through to completion of such initiatives that include but are not limited to: Preparation and review of Medicare, Medicaid, OSHPD, and all manner of other regulatory reports, Wage index reviews, Medicaid Eligible Days reviews, various cost based reimbursement strategies, and any reimbursement methodology related to Medicare and Medicaid that have reimbursement implications.

The Senior Manager Reimbursement – Regulatory Reporting is responsible for ensuring compliance with all government reimbursement regulations and ensures adequacy of internal controls related to such are periodically assessed for adequacy. The Senior Manager is also responsible for the efficient operation of the functional team, including mentoring of staff, assessing current workloads, and providing adequate prioritization of reimbursement-related projects.

In this position you will:

  • Manage all direct reports and review all their work papers and supporting documentation prior to submitting for quality review. If assisted by a Lead Analyst, is still responsible for final approval.

  • Prepare Medicare and Medicaid cost reports, OSHPD, and other regulatory filings, and the related work papers in accordance with all applicable regulations and PSJH policies under the guidance of the Director.

  • Communicate results to hospital financial leaders including reconciling the cost report to the expected settlement amount per internal third party settlement calculations.

  • Prepare and analyze proposed audit adjustment impacts and submit additional documentation as required by the MAC or regulatory agency.

  • Prepare Medicare and Medicaid appeals and supporting documents for filing with the Provider Reimbursement Review Board or other governing body as necessary in coordination with the Reimbursement Strategy pillar.

  • Assist with developing, maintaining, supporting, training, and implementation of standard templates for such things as cost report preparation and monthly 3rd party settlement analyses.

  • Prepare monthly workbooks and resultant journal entries to record third party settlements, and provider taxes payable and supplemental payments receivable. Assist the Director in validating that workbooks stay current with regulatory changes.

  • Perform financial analyses and provide technical support for Reimbursement leadership, Finance, Revenue Cycle, and other departments, as requested.

  • Continuously monitor workload and methodologies used to achieve results, making recommendations to improve efficiency and/or achieve cost savings whenever possible.

  • Ensure that all assigned statutory filings are timely and accurate.Coordinate preparation of documents for annual financial statement audits, and serve as liaison with external auditors.

  • Keep the Director apprised of reporting issues within the office and seeks assistance in a timely manner such that critical deadlines are kept.

Qualifications:

Required qualifications for this position include:

  • Bachelor’s degree in Accounting, Finance or Mathematics/Statistics - or an equivalent combination of education and/or experience.

  • Minimum 8 years demonstrated experience in the reimbursement field is required, with some experience in a leadership or supervisory role is required, and expert knowledge of current reimbursement and reporting rules and regulations.

Preferred qualifications for this position include:

  • Previous work experience in consulting, in a multi-hospital system, or MAC.

  • CPA or CHFP.

About the department you will serve.

Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence Health & Services from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.

We offer a full comprehensive range of benefits - see our website for details

http://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Non-Clinical Lead/Supervisor/Manager

Location: Washington-Renton

Other Location(s): Washington-Spokane, Oregon-Portland, California-Burbank, California-Irvine

Req ID: 219899

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