Senior Director, Medicare & Medicaid Reimbursement

Director Location: 95 Old Short Hills Road, West Orange, NJ 07052. Department: Corporate Reimbursement. Status: Full-Time. Shift: Day. Pay Range: $144,485.00 - $209,500.00 per year. Pay Transparency: The above reflects the anticipated annual salary range for this position if hired to work in New Jersey. The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills, and professional experience. Overview The Director will serve as a key resource to department leadership for providing Medicare and Medicaid reimbursement support and implementing government payment strategies across all RWJBarnabas Health hospitals. This includes planning, preparing and reviewing the annual Medicare/Medicaid cost reports filings; managing the completion of DSH, Medicare Bad Debts, Wage Index, and Geographic Reclassification projects; closely assessing, tracking, and monitoring participation in state-level supplemental payment programs; assisting with regulatory research; and overseeing accurate determination of third‑party receivables/payables, ensuring revenue and receivables reporting complies with GAAP. Minimum Requirements BS/BA in Accounting, Finance, or Health Administration required Minimum of 10 years of experience interpreting Medicare and Medicaid payment regulations, ensuring optimization of revenue and completing Medicare and Medicaid cost reports Expert level knowledge of Medicare and Medicaid regulation and payment rules is essential Ability to interpret Medicare and Medicaid payment regulations and develop and implement processes ensuring hospitals are reimbursed for all programs and services is required Education on and adherence to Generally Accepted Accounting Principles (GAAP) Proactive prioritization of needs and effective resource management Delegation and training to meet deadlines; clear, concise communication Guiding individuals and groups toward desired outcomes with minimal supervision, setting high performance standards and delivering high quality services Decisive decision‑making skills and escalation of issues to supervisor as appropriate Establishment and maintenance of long‑term customer relationships, building trust and respect by consistently meeting and exceeding expectations Coordination with leadership and deployment of resources as directed (e.g., Cost Report preparation, Wage Index) Proficiency in Microsoft Office applications (Excel, Word) and others as required Preferred: HFMA Certification Duties & Responsibilities Prepare Medicare and Medicaid cost reports and supporting forms/schedules as required Responsible for the completion and review of the annual New Jersey Acute Care Hospital (SHARE) cost reports Monitor and validate state and federal issued reimbursement rates Investigate and respond to audit reviews, questions, and adjustments Regularly monitor and evaluate changes in reimbursement regulations and policies to optimize reimbursement opportunities Monitor Medicare and Medicaid appeal and cost report reopening issues Complete Medicare 855As (and Medicaid) when applicable such as Change of Ownership (CHOW) and Change of Information applications Complete the annual Medicaid DSH Surveys Manage and optimize the data collection and reporting process for the Medicare, Medicaid and NJ SHARE cost reports (Physician Time Studies, Contracted Labor, A‑6 Reclasses, and B‑re federal regulations) Assist in orientation, training and development of new Financial Analysts as needed Supervise Financial and Senior Financial Analyst(s) in completion of certain projects when assigned by senior management Assist in Reimbursement Department projects not listed above Assist in special projects as needed Other work duties as assigned Benefits and Perks Paid Time Off including Vacation, Holidays, and Sick Time Retirement Plans Medical and Prescription Drug Insurance Dental and Vision Insurance Disability and Life Insurance Paid Parental Leave Tuition Reimbursement Student Loan Planning Support Flexible Spending Accounts Wellness Programs Voluntary Benefits (e.g., Pet Insurance) Community and Volunteer Opportunities Discounts through our partners such as NJ Devils, NJ PAC, and Verizon Equal Opportunity Employer #J-18808-Ljbffr RWJBarnabas Health