Director of Revenue & Reimbursement

Director, Revenue and Reimbursement

Reporting to the Senior Director of Financial Planning, the Director, Revenue and Reimbursement directs the day-to-day operations of the Revenue and Reimbursement area, including the administration of more than $3B of Patient Revenue, the filing of DFCI's Medicare and State cost reports including the management of their associated governmental audits, the strategic decision-making regarding the valuation of balance sheet reserves such as 3rd party liabilities, provision for bad debt, and health safety net, and providing timely and accurate reporting and analyses to Senior Management on reimbursement and other finance related activities and outcomes.

Located in Boston and the surrounding communities, Dana-Farber Cancer Institute is a leader in life changing breakthroughs in cancer research and patient care. We are united in our mission of conquering cancer, HIV/AIDS, and related diseases. We strive to create an inclusive, diverse, and equitable environment where we provide compassionate and comprehensive care to patients of all backgrounds, and design programs to promote public health particularly among high-risk and underserved populations. We conduct groundbreaking research that advances treatment, we educate tomorrow's physician/researchers, and we work with amazing partners, including other Harvard Medical School-affiliated hospitals.

Primary Duties and Responsibilities:

• Responsible for the annual budgeting, forecasting, accounting, summarizing, and communicating the results, variances, and reconciliations of more than $3B of annual Patient Revenue and associated patient related volume. Work closely with various clinical division administrators during operational planning and clinical budgeting and revenue modelling process. Coordinate with the Director of Business Planning & Senior Director of Budget to develop assumptions for patient revenue for the Institute's Multi-Year Financial Forecast and annual Budget.
• Responsible for the annual filing and audit of the Institute's Medicare cost report, which covers approximately $500M of reimbursement from Medicare. This is a unique responsibility as DFCI is one of only 10 dedicated cancer centers in the country who are exempt from Medicare PPS reimbursement methodologies.
• Collaborate with Payor External Affairs to provide support and analyses related to the regulatory structure and rate setting for governmental payors. Collaborate with Payer Contracting & Performance department to provide strategic support and financial analysis in contract negotiations with payors. Participate in and provide strategic input to various projects associated with the Alliance for Dedicated Cancer Centers (ADCC). Keep up to date with changes in Federal and State laws, regulations, policies, and proposals related to governmental and private payors. Build and maintain strong relationships with consultants, payers, government agencies, and other stakeholders.
• Oversee the monthly financial statement closing process as it relates to valuing NPSR and 3rd Party Liabilities. Present analysis to Senior Financial Management on related actual to budget variances, volume trends, etc.
• Direct staff and activities within the reimbursement function. Hire, develop, and manage staff to achieve organizational goals. Set clear expectations, deliver feedback, and monitor performance for quality, efficiency, and compliance with policies and procedures. Mentor staff, foster career growth, and cultivate a positive and productive work environment.
• Interface and collaborate with Financial Planning and Accounting staff, Senior Management, and department managers, to produce clinical and financial ad hoc reports and analyses. Participate in committees and teams related to rate sensitivity reviews, revenue enhancements, revenue cycle, improved charge capture. Manage analysis and completion of benchmarking, surveys, and other competitive data for both internal and external customers.
• Perform continuous review of Revenue and Reimbursement functions and business processes for streamlining opportunities and improvements to operational efficiency. This includes establishing departmental goals and promoting cross-training to further develop the staff.

Knowledge, Skills and Abilities:

• Expert knowledge of hospital payment methodologies for inpatient and ambulatory treatments, government and commercial payors, PPS and PPS exempt payment methodologies, including experience with oncology services. Expertise and a high-functioning knowledge of the Medicare cost report and cost-based reimbursement.
• Excellent interpersonal and communication skills to effectively collaborate and communicate with all levels of internal staff remotely. This includes the CFO, VP of Finance, other Vice Presidents, and various Department Administrators, Directors, and Managers.
• Strong demonstrated ability to develop, manage, and maintain relationships, including the ability to effectively negotiate with representatives from governmental and commercial payors, external auditors, consulting and legal representatives, and industry experts.
• Ability to understand, predict, and manage the accounting and valuation of receivables, liabilities, and patient revenue on the financial statements.
• Excellent working knowledge of the mechanics of drug expense and revenue in a hospital setting.

Job Qualifications:

• Bachelor's Degree accounting, finance or related field, Master's Degree preferred business administration or equivalent
• 8 years of relevant healthcare industry work experience with at least 5 of those years spent in a supervisory capacity in a hospital environment.
• 10 years of relevant experience.
• Hands-on experience with inpatient and outpatient cost reporting of complex health systems. Experience with the overall finances of novel and high-end therapies like CAR-T, Theranostics, and Bone Marrow/Stem Cell transplants.

Supervisory Responsibilities:

• Directly supervises Manager, Finance. Indirectly supervises a team of Reimbursement Analysts.

At Dana-Farber Cancer Institute, we work every day to create an innovative, caring, and inclusive environment where every patient, family, and staff member feels they belong. As relentless as we are in our mission to reduce the burden of cancer for all, we are committed to having faculty and staff who offer multifaceted experiences. Cancer knows no boundaries and when it comes to hiring the most dedicated and compassionate professionals, neither do we. If working in this kind of organization inspires you, we encourage you to apply.

Dana-Farber Cancer Institute is an equal opportunity employer and affirms the right of every qualified applicant to receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, national origin, sexual orientation, genetic information, disability, age, ancestry, military service, protected veteran status, or other characteristics protected by law.