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Director Government Reimbursement & Managed Care

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Location: Buffalo, NY, United States
Date Posted: Jul 7, 2020

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Job Description

Facility: Administrative Regional Training Cntr

Status: Full Time

Work Schedule: Days

Bargaining Unit: ACE Associates

Exempt from Overtime: Exempt: Yes

Hours:

Shift: Shift 1:

FTE: 1.000000:



Summary:

The Director of Government Reimbursement and Managed Care ensures the appropriate capture of Government revenue across the entire Catholic Health system. The Director is responsible for the coordination, completion and timely filing of all cost reports (acute, long-term care, home care), all Medicare and Medicaid rate reviews for acute, long term care, and home care, and coordination and timely filing of appeals to the NYS Department of Health and CMS. The Director is responsible for the collection and preparation of data, analysis of accounting and related systems, regulatory submissions, fiscal presentations for budget and other forums as needed. The role assists with reimbursement related projects such as DSH, IME, HCRA and other 3rd party reporting. The Director develops and executes managed care strategies, negotiates contract rates and provisions for all Catholic Health entities (acute, LTC and home care) in conjunction with Catholic Medical Partners (CMP), manages the Catholic Health network contracting team. These functions include multidisciplinary interaction with various aspects of Catholic Health and Catholic Medical Partners as well as management of and, as needed, significant analysis and reporting functions. The Director is responsible for ongoing communication throughout the organization and maintaining strong relationships with the Finance team, Revenue Management Team and Business owners of Catholic Health impacted by government and managed care reimbursement.



The Director will adhere to Hospital Standards of Conduct and practices the Core Values of Service of the Poor, Reverence, Integrity, Wisdom, Creativity and Dedication.



The Director represents Catholic Health (CH) accurately and honestly and acts with integrity and in the best interest of CH. The Director identifies instances of non-compliance and takes appropriate action, including reporting violations of the CRP. The Director will adhere to Hospital policy or regulations. Business relationships are conducted in the best interest of CH, free of gifts, favors or other improper inducements.

Responsibilities:

EDUCATION
  • Bachelor's Degree
  • Master's Degree or CPA preferred
EXPERIENCE
  • Seven (7) years in healthcare reimbursement
  • Supervisory experience
KNOWLEDGE, SKILL AND ABILITY
  • Knowledgeable of Federal and State Healthcare reimbursement and financial analysis
  • Extensive use of Excel including Pivot Tables, V Look Up and Macros
  • Use of PowerPoint
  • Strong knowledge of financial management
  • Good strategic planning, analytical, and organization skills
  • Demonstrated ability to work well in a team setting
  • Strong written and verbal communication skills
  • Strong interpersonal and leadership skills
  • Comfort in working in a matrix environment
  • Ability to work independently

WORKING CONDITIONS

ENVIRONMENT
  • Normal heat, light space, and safe working environment; typical of most office jobs


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