VP Reimbursement and Cost Reporting

Position Summary:

The VP of Reimbursement and Cost Reporting will drive the completion of Medicare Cost Reports and other government financial filings, as well as support audits and act as a subject matter expert on government reimbursement policy and reporting. They ensure our company and hospital systems are well informed on how changes within its business operations or that are regulatory or legislative driven will impact the Medicare Cost Report. This will require maintaining a high degree of knowledge on cost reporting instructions, data inputs, and changes to Medicare and Medicaid regulations. The VP will be the day-to-day lead on many reimbursement team activities and will be responsible for proactively completing projects on the annual cost reporting and promptly responding to requests from external auditors and internal leadership.

Responsibilities:

Serve as the point person for planning, collecting, analyzing, and trending hospital Medicare Cost Report data. This will include using databases querying logic to pull data sets from financial systems.

Complete the Medicare Cost Report, including working with accounting and internal leadership to properly map internal financials to appropriate cost report lines, preparing the data using pivot tables or other Excel tools, entering the cost reporting data into the relevant software, and submitting the cost report to CMS.

• Complete other government financial filings required by Medicare and Medicaid programs.
• Liaise with external vendors supporting the cost reporting and reimbursement functions.
• Manage correspondence with Medicare and Medicaid entities and contractors on issues related to cost reports, audits, surveys, etc.
• Assist with reimbursement audits, desk reviews, rate updates, surveys, and other similar requests conducted by Medicare or Medicaid (or any assigned third party) and determine the impact of any audit adjustments to management.
• Collaborate with Managed Care team to review Medicare factors on a quarterly basis to ensure system expected payment calculator is programmed with correct Medicare factors.
• Collaborate with Accounting to review and revise reserve accounts tied to cost reporting and other reimbursement function activities as well as to understand the relationship between the cost report and other internal and external financial and tax reporting.
• Maintain current knowledge of regulatory and legislative changes and their influence on reimbursement.
• Support the creation and delivery of presentations to finance and executive leadership on reimbursement and cost reporting topics upon request.
• Develop and manage team members, including education and training, professional development, and performance reviews. Delegate projects and oversee completion and reporting on results.
• Additional support to Finance Division management upon request.

Education / Experience:

• B.S. Degree in Accounting, Business, Healthcare Administration, or another related field.
• Minimum of five (5) years relevant experience in the healthcare industry with at least three (3) years in a directly related leadership role.
• Experience in Cost Report preparation and review.
• Knowledge and understanding of government payor reimbursement.
• Excellent communication and interpersonal skills.
• Must demonstrate strong analytical skills and attention to detail.
• Intermediate skill level with Excel
• Ability to work independently and as part of a team.
• Time management skills and the ability to prioritize tasks effectively.