at Christiana Care Health System in Wilmington, Delaware, United States
Under the direction of the Director, Decision Support and Reimbursement, this position leads the reimbursement and cost reporting functions of ChristianaCare. Oversite of these functions, and the management of the departmental staff supporting these functions, will ensure that reimbursement systems are maintained in a manner to comply with regulatory standards and evaluated to preserve the organizational vitality goals of ChristianaCare.
When you become an employee at ChristianaCare, you are joining a healthcare organization that was named Forbes 5th Best Health System to Work for in the U.S. for 2021! Guided by excellence and love, our Caregivers enjoy many employee benefits such as
competitive pay and benefits
generous paid time off
Primary duties and responsibilities:
Manages the staff, processes, and procedures necessary to evaluate, maintain and submit Medicare cost reports, third-party reimbursements, and other reports and questionnaires that are consistent with organizational goals and expectations.
Manages the staff, processes, and procedures necessary to evaluate, maintain, and submit HSCRC reporting on a month, quarterly, and annual basis.
Manages the staff, processes, and procedures to ensure HSCRC rates are properly evaluated and set in a manner to comply with HSCRC regulations.
Responsible for the positive resolution of third-party audits and inquiries through management of reimbursement staff, direct communication with third-party representatives, and keeping Finance Leadership informed on a timely basis.
Manages the analysis of regulatory changes and communicates the impact to Finance Leadership.
Collaborates with internal and external department staff to address regulatory impacts.
Provides education to system leadership and staff on regulatory changes and reimbursement impacts from all third-party payors.
Responsible for the compliance of 340B regulations and keeping Finance Leadership informed on a timely basis.
Provides for the calculation and the report of reimbursement rates to be utilized in third-party reserves, financial forecasts, and annual budgets.
Responsible for the timely and accurate maintenance of third-party contract modeling.
Collaborates with Managed Care Contracting staff to ensure third-party reimbursement model assumptions are updated timely and accurately to support the evaluation of payment options.
Collaborates with Managed Care Contracting staff and external vendors to maintain contract modeling software.
Collaborates with Departmental Leadership and staff to support the development and evaluate the impact of alternative payment models.
Education and experience requirements:
BS/BA in Accounting or Finance required; MS/MBA preferred.
Active professional certification of financial relevance desirable.
At least six years of experience in a major acute care teaching hospital setting or equivalent.
Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.